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Computational and Mathematical Methods in Medicine
An Interdisciplinary Journal of Mathematical, Theoretical and Clinical Aspects of Medicine
Volume 9, 2008 - Issue 1
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Original Articles

Correlation of mechanical factors and gallbladder pain

, , , , , & show all
Pages 27-45 | Received 02 Jul 2007, Accepted 31 Oct 2007, Published online: 22 Jan 2008
 

Abstract

Acalculous biliary pain occurs in patients with no gallstones, but is similar to that experienced by patients with gallstones. Surgical removal of the gallbladder (GB) in these patients is only successful in providing relief of symptoms to about half of those operated on, so a reliable pain-prediction model is needed. In this paper, a mechanical model is developed for the human biliary system during the emptying phase, based on a clinical test in which GB volume changes are measured in response to a standard stimulus and a recorded pain profile. The model can describe the bile emptying behaviour, the flow resistance in the biliary ducts, the peak total stress, including the passive and active stresses experienced by the GB during emptying. This model is used to explore the potential link between GB pain and mechanical factors. It is found that the peak total normal stress may be used as an effective pain indicator for GB pain. When this model is applied to clinical data of volume changes due to Cholecystokinin stimulation and pain from 37 patients, it shows a promising success rate of 88.2% in positive pain prediction.

Acknowledgements

We would like to thank SWANN MORTON Ltd, Universities of Sheffield and Glasgow, for the financial support for this research. Helpful discussions with Dr Aitchison of the Department of Statistics, University of Glasgow are gratefully acknowledged.

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