The Relationship Between Contractility Of Gallbladder,Postoperative Bowel Movement And The Density Of Cajal Cells In Gallstone Patients

Objective:To investigate the relationship among the contractility of gallbladder,the desity of Cajal cells and the bowel movement after cholecystectomy.Method:Consecutive patients who would undergo cholecystectomy were recruited between February to March 2017 and divided into two groups:study group with gallstone and control group without gallstone.Clinical data such as age,the year when the gallstone was first found,the ultrasound result before surgery and the present history were recorded and the contractility of gallbladder was gotten by fat meal test using ultrasound examination.Pathologic specimens were obtained from the neck,body and fundus of the gallbladder and embedded respectively.Cajal cells and mast cells were identified by immunofluorescence,and then the number of Cajal cells and the integrated optical density of CD117 were recorded and compared between two groups.A two-mouth follow up was done to know the altered bowel movement after cholecystectomy.Result:Totally 25 patients were included in this study,with 17 in study group and 8 in control group.The number of interstitial Cajal cells in gallbladder wall and contraction of gallbladder between two groups were of significantly statistical difference(89.59±28.77 vs 115.89±27.87,P=0.036 and 42.05%±17.19%vs 59.75%±21.21%,P=0.042),but the relationship between the number of interstitial cell of Cajal and contraction of gallbladder did not present significant correlativity by Pearson correlation analysis.No significant result of postoperative bowel movement were found between the two groups.In the subgroup analysis,the contraction of gallbladder in patients with postoperative altered bowel movement and the patients without alter bowel movement has significant difference(37.25%±13.14%vs 57.45%±21.55%,P=0.012),and the contraction of gallbladder has positive status in logistic analysis.Conclusion:Compared with patients without gallstone,the number of interstitial cell of Cajal decreased and the percentage of contraction of gallbladder also got damaged in study group,but the two parameters were not in simple linear correlation.The change of bowel movement after cholecystectomy was mainly influenced by the contraction of gallbladder,but not gallstone.