The Related Factors Between Liver Cirrhosis And Gallbladder Stone

Liver cirrhosis is a chronic , progressive disease, which is the end result of hepatocellular degeneration and necrosis that leads to both fibrosis and nodular regeneration throughout the liver, cirrhosis spreads all over the world, also in China. The primary clinical features of cirrhosis result from liver disfunction and portal hypertension. Gallstones' formation mostly related with impaired gallbladder contractility, biliary tract infection ,cholesterol supersaturation and changed composition of bile. Liver is the primary organ that produces bile, bile's metabolization mostly relies on the normal form and function of liver, therefore, it is considered that there is significant relationship between the liver and the formation of gallstones, it has been noted that gall-stones are common in patients suffering from cirrhosis, which is 4-5 times higher than general population. Since the invention of B-ultrasonography, CT and MRI and the therapeutic progression of cirrhotic complications, it prolongs the survival length of the cirrhotic patients. So, attention were again paid to the prevalence of gallstones in cirrhotics. As yet, it is not clear whether cirrhosis related with the riskfactor,such as age, previous alcohol abuse, child-pugh, serum levels of albumin and ascites, influences gallstones increased frequency.ObjectiveWe retrospectively studied one hundred and twenty two cirrhotic inpatients, aimed to evaluate the prevalence of gallstones and related risk factors in a large series of patients with cirrhosis.MethodsOne hundred and twenty two consecutive cirrhotic patients (16 Child A, 34 Child B and 72 Child C) hospitalized in the department of gastroenterology of Sir Run Run Shaw Hospital, between January 2001 and January 2004, were included.liver function tests, coagulation function and abdominal B-ultrasonography were performed , all these patients were confirmed as suffering from liver cirrhosis. Aimed to evaluate the frequency of gallstones and study the relationship between gallstones and gender, age, previous alcohol abuse, Child-pugh, the inside diameter of portal vein, serum levels of albumin and total bilirubin, prothrombin time, gallbladder wall thickening and ascites.ResultsThe overall prevalence of gallstones was 29.51%(36/122) in our cirrhotic patients ,more higher than that of the control group(5.70%,13/228).Of the 122 study subjects ,twenty-eight of the 78 inpatients(35.90%) in the group of inside diameter of portal vein >13mm had gallstones, far higer than that of the inside diameter of portal vein≤13mm(18.18%), P<0.05. The prevalence of gallstones significantly difference between Child's class A (2/16,12.50%) ,Child's class B(6/34,17.65%) and Child's class C (28/72,38.89%), P<0.01. Logistic regression analysis showed that the presence of ascites and Child-pugh were the risk factors for the gallstones in patients with liver cirrhosis (0R=4.019, P=0.002; 0R=4.062, P=0.040) . No relationships with the factors for the prevalence of gallstones in liver cirrhosis, such as age , sex, previous alcoholabuse, serum levels of albumin , gallbladder wall thickening or prothrombin time,were found.Conclusions1. Gallstones in our cirrhotic patients more prevalent than in general population.2. Sex, Age , previous alcohol abuse, serum levels of albumin, gallbladder wall thickening and prothrombin time did not influence in gallstones prevalence in our cirrhotic patients.3. Child-Pugh class and presence of ascites were the risk factor for the gallstones in patients with liver cirrhosis.4. The severity of liver disfunction and portal hypertension may be associated with an in increased risk of gallstone formation, the patients with severe liver function and higher portal pressure are more likely to have gallstones.