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Cirrhosis of the liver. A risk factor for development of cholelithiasis in males
F Fornari1, G Civardi, E Buscarini
1I Divisione di Medicina, Servizio di Gastroenterologia, Ospedale di Piacenza, Italy.
Insights
Cirrhosis significantly increases the risk of gallstone disease, particularly in males. This study suggests hormonal factors, like elevated estrogens, may contribute to impaired gallbladder function in cirrhotic patients.
Area of Science:
- Hepatology
- Gastroenterology
- Radiology
Background:
- Gallstone disease (cholelithiasis) is a common condition.
- Cirrhosis of the liver affects gallbladder function and motility.
- The relationship between cirrhosis and gallstone prevalence requires further investigation.
Purpose of the Study:
- To determine the prevalence of cholelithiasis in patients with cirrhosis compared to controls.
- To investigate the influence of sex, cirrhosis etiology, and disease severity on gallstone formation.
Main Methods:
- An ultrasonographic study was conducted.
- 410 patients with liver cirrhosis and 414 age- and sex-matched controls were included.
- Prevalence of gallstones was compared between groups.
Main Results:
- Gallstone disease was significantly more prevalent in cirrhotic patients (31.9%) than in controls (20.7%).
- This difference was significant in males (30.2% vs 16.5%) but not females.
- Gallstone prevalence increased with cirrhosis severity (Child's A to C), especially in males.
Conclusions:
- Liver cirrhosis is a risk factor for developing gallstones, particularly in males.
- Estrogen levels may play a role in impaired gallbladder emptying in cirrhotic males.
- Cirrhosis severity correlates with increased cholelithiasis risk.
Abstract:
An ultrasonographic study about the prevalence of cholelithiasis was performed in 410 cirrhotic patients and in 414 controls matched for age and sex. Gallstone disease was found more often in cirrhotic patients (31.9%) than in controls (20.7%) (P less than 0.001). The female-to-male ratio of gallstones prevalence in cirrhotic patients approached to 1:1. Gallstone disease in cirrhotic patients vs controls was significantly higher (30.2% vs 16.5%) (P less than 0.001) in males only. No difference was found, for gallstone disease prevalence in cirrhosis of different etiology. The prevalence of cholelithiasis increased from Child's A to Child's C with a significant trend (P less than 0.001); this difference was significant in males (12.3% vs 40.5%) (P less than 0.001) but not in females. This study shows that cirrhosis represents a risk factor for the development of cholelithiasis in males. We suggest that high levels of estrogens could play a role in these patients, by an impairment of gallbladder emptying similar to that observed in pregnant women.