Possible Relationship Between Cholecystectomy And Subsequent Occurrence Of Primary Intrahepatic Lithiasis:a Retrospective Review Of Data

Objective: To investigate the correlation between cholecystectomy and primary intrahepatic lithiasis.Methods:We retrospectively collected the case histories of276primary intrahepatic lithiasis patients as test group and290hepatic hemangioma patients as control group, which were all admitted into Qilu hospital of Shandong university during Jan.2007to Dec.2011. Univariate analysis were used to reveal the correlation of cholecystectomy and the formation of primary intrahepatic lithiasis.Results:There were276patients in the test group who suffered from primary intrahepatic stones (PIS)(male123, female153), from20years old to71years old at an average of41.4years old.290patients were collected in the control group who suffered from cavernous hemangioma of liver (male124, female166), from19years old to74years old at an average of45.5years old. In PIS group,39patients have underwent cholecystectomy (male21, female18), while in the control group, only25patients have underwent cholecystectomy (male11, female14). The rate of cholecystectomy was significantly higher in PIS group than the control group (χ2=4.281, P=0.039; OR=1.639,95%CI1.020-2.634), which suggested cholecystectomy might be associated with PIS. There was a significant deviation in female patients who had underwent cholecystectomy between the two groups (χ2=4.446, P=0.035), while there was no significant deviation in male patients (χ2=0.612, P=0.434). Gallbladder stones were main reason of cholecystectomy in PIS patients. Among the patients with cholecystectomy history, more gallbladder stones patients were found in PIS group than the control group, however, there was not detectable statistical significance (χ2=3.209, P=0.073). There are no statistically significance between the patients who had underwent cholecystectomy and those who hadn’t in the test group in sex composition, age, the level of total bilirubin, cholangitis and the distribution of stones in liver (P>0.05). Compared with the patients who didn’t underwent cholecystectomy, the patients who had underwent cholecystectomy usually had increased WBC(white blood cells)(P=0.045) and they seem to form stenosis of Oddi’s sphincter more easily(P=0.041).Conclusions:1. Patients who underwent cholecystectomy are more easily to suffer from primary intrahepatic lithiasis.2. Patients who underwent cholecystectomy usually had increased WBC3. Patients with primary intrahepatic lithiasis who had underwent cholecystectomy seem to form Oddi’s sphincter stenosis more easily.