This article was last reviewed and updated on May 29, 2019.
by Shaheed Hakim, MD FRCPC
Chronic cholecystitis is a medical condition typically caused by gallstones in the gallbladder.
The gallstones cause inflammation in the gallbladder which can lead to pain, especially after eating fatty foods.
The normal gallbladder
The gallbladder is a small organ attached to the liver. It is located in the upper abdomen just to the right of the stomach. The liver produces a liquid called bile which flows into the gallbladder. The purpose of the gallbladder is to concentrate, store, and release bile, which helps in digestion of fats in our food.
Bile normally flows easily out of the gallbladder and into the small intestine. However, in some people, the bile becomes thick and solid clumps start to form. These clumps can eventually become gallstones that can get stuck in the gallbladder or the channel that leads from the gallbladder to the small intestine. Pathologists called gallstones cholelithiasis.
The most common type of gallstone in Canada, United States and Western Europe is called a cholesterol gallstone. Infections and rare diseases can cause another type of stone, called a pigmented gallstone.
What is chronic cholecystitis?
Chronic cholecystitis is a non-cancerous condition that develops when gallstones or thick bile block bile from flowing out the gallbladder. This leads to inflammation and over time, the gallbladder becomes unable to function normally.
Patients with gallstones typically experience pain in the right side of the abdomen just below the rib cage and the pain can radiate to the shoulder or back. A diagnosis of cholecystitis with cholelithiasis means that your pathologist has identified signs of gallbladder inflammation (acute or chronic) as well as identified the presence of gallstones.
The earliest change is referred to as 'low' grade dysplasia. The cells in low grade dysplasia are abnormal but are still non-cancerous (benign). In some cases, the cells become even more abnormal and progress to 'high' grade dysplasia. These cells look very similar to cancer cells, however, they are only seen in the epithelium on the inner surface of the stomach.
High grade dysplasia is considered a precursor disease because some cases will turn into cancer (a malignant tumour) over time. Your pathologist will closely examine the tissue for any evidence of dysplasia and will describe it in your report if it is seen.
It is very rare to find dysplasia in a gallbladder removed for chronic cholecystitis and it will only be described in your report if it is seen.