학술논문
Gallstone and Gallbladder Disease: Biliary Tract and Cholangiopathies
Document Type
Reference
Author
Ludovica Ceci, author; Yuyan Han, author; Kelsey Krutsinger, author; Leonardo Baiocchi, author; Nan Wu, author; Debjyoti Kundu, author; Konstantina Kyritsi, author; Tianhao Zhou, author; Eugenio Gaudio, author; Heather Francis, author; Gianfranco Alpini, author; Lindsey Kennedy, author
Source
Comprehensive Physiology. :4909-4943
Subject
Language
English
Abstract
Cholestatic liver diseases are named primarily due to the blockage of bile flow and buildup of bile acids in the liver. Cholestasis can occur in cholangiopathies, fatty liver diseases, and during COVID‐19 infection. Most literature evaluates damage occurring to the intrahepatic biliary tree during cholestasis; however, there may be associations between liver damage and gallbladder damage. Gallbladder damage can manifest as acute or chronic inflammation, perforation, polyps, cancer, and most commonly gallstones. Considering the gallbladder is an extension of the intrahepatic biliary network, and both tissues are lined by biliary epithelial cells that share common mechanisms and properties, it is worth further evaluation to understand the association between bile duct and gallbladder damage. In this comprehensive article, we discuss background information of the biliary tree and gallbladder, from function, damage, and therapeutic approaches. We then discuss published findings that identify gallbladder disorders in various liver diseases. Lastly, we provide the clinical aspect of gallbladder disorders in liver diseases and ways to enhance diagnostic and therapeutic approaches for congruent diagnosis. © 2023 American Physiological Society. Compr Physiol 13:4909‐4943, 2023.
Didactic Synopsis Major Teaching Points The gallbladder is a specialized organ that plays roles in bile modification and digestion of fats. Gallbladder damage can manifest as acute or chronic inflammation (cholecystitis), perforation, polyps, cancer, and more commonly gallstones (cholelithiasis). The gallbladder epithelial cells closely resemble those of the intrahepatic biliary tree, but distinct differences may account for specialized functions. Bile duct damage characterized by inflammation, fibrosis, and ductular reaction can be found in primary sclerosing cholangitis (PSC), primary biliary cholangitis (PBC), alcohol‐related liver disease (ARLD), nonalcoholic fatty liver disease (NAFLD), cholangiocarcinoma (CCA), and COVID‐19. There is an association between gallbladder disorders and bile duct damage, but direct links are unknown. In some liver diseases, having congruent gallbladder damage increases morbidity and mortality in patients. Current work is underway that evaluates different modalities that may be beneficial for the diagnosis or treatment of gallbladder disorders, specifically in the setting of liver disease.
Didactic Synopsis Major Teaching Points The gallbladder is a specialized organ that plays roles in bile modification and digestion of fats. Gallbladder damage can manifest as acute or chronic inflammation (cholecystitis), perforation, polyps, cancer, and more commonly gallstones (cholelithiasis). The gallbladder epithelial cells closely resemble those of the intrahepatic biliary tree, but distinct differences may account for specialized functions. Bile duct damage characterized by inflammation, fibrosis, and ductular reaction can be found in primary sclerosing cholangitis (PSC), primary biliary cholangitis (PBC), alcohol‐related liver disease (ARLD), nonalcoholic fatty liver disease (NAFLD), cholangiocarcinoma (CCA), and COVID‐19. There is an association between gallbladder disorders and bile duct damage, but direct links are unknown. In some liver diseases, having congruent gallbladder damage increases morbidity and mortality in patients. Current work is underway that evaluates different modalities that may be beneficial for the diagnosis or treatment of gallbladder disorders, specifically in the setting of liver disease.