Meta-analysis On Influence Factors Of The Liver Cirrhosis With Gallstones In China

Background and ObjectiveThe liver is the main organ of bile production,and the normal metabolism of bile depends,to a great extent,on the normal shape and function of the liver.Due to the relationship of the anatomical location between liver and gallbladder,liver cirrhosis and gallbladder stones often cause,effect and promote each other in the pathological state,A large number of medical reports indicate that the incidence of cirrhosis with gallbladder stones is significantly higher than the general population.The clinical symptoms of cirrhosis complicated with cholecystolithiasis are not typical or are covered up by the symptoms of cirrhosis itself,which may easily lead to missed diagnosis and delayed illness.It will aggravate the damage of liver function and increase the cost and treatment difficulty of cirrhosis.Surgical treatment to gallbladder stones in patients with liver cirrhosis has a high risk and lots of surgical complications.In order to prevent and reduce the incidence of gallbladder stones in patients with cirrhosis,it is necessary to clarify its influence factors.In this paper,a meta-analysis was conducted on the case-control studies published at home and abroad on the factors affecting the occurrence of cirrhosis complicated with cholecystolithiasis in China,so as to provide a reference for the prevention of cirrhosis complicated with cholecystolithiasis.MethodsCNKI,Wanfang database,PubMed,Embase and Cochrane Library were retrieved on the liver cirrhosis with gallbladder stones in China from 2000 to 2018,and all studies included were case-control studies.The retrieved literatures were screened,quality evaluated and data extracted,and statistical analysis was performed by using the Review Manager 5.3 software provided by the Cochrane collaboration website.ResultsA total of 23 references were enrolled in this study.The Meta-analysis showed that age(MD=6.19,95%CI:4.1 0-8.28),the diameter of portal vein>13mm(OR=2.26,95%Cl:1.70-3.00),the thickness of gallbladder wall>4mm(OR=3.32,95%CI:2.15-5.12),Child-Pugh Grade C of liver function(OR=2.28,95%CI:1.81?2.85),serum albumin concentration(MD=-3.23,95%CI:-4.23?-2.23),serum total bilirubin concentration(MD=4.49,95%CI:2.31?6.68),ascites(OR=2.70,95%CI:1.29?5.65)and estrogen concentration(MD=5.31,95%CI:4.1 7?6.45)are the influence factors of cirrhosis complicated with gallstones in China.There was no significant correlation between sex and causes of cirrhosis and cirrhosis with gallstones.Compared with those without gallstones,patients with gallstones in cirrhosis had a longer course of disease(MD=3.10,95%CI:0.74-5.46)and this difference was statistically significant.ConclusionsThe occurrence of gallstones in patients with liver cirrhosis may be related to the severity of liver disfunction and portal vein hypertension.The rate of incidence rises up with the increase of patients' age and the prolongation of the course of liver cirrhosis.By improving liver function,reducing portal venous pressure,correcting hypoalbuminemia and preventing hyperbilirubinemia,it is expected to reduce the incidence of gallstones in patients with liver cirrhosis.