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Clinical significance of cholelithiasis in patients with decompensated cirrhosis
Insights
Cirrhosis increases gallstone (cholelithiasis) risk, but the exact cause remains unclear. This study found gallstones do not impact survival rates in patients with decompensated cirrhosis.
Area of Science:
- Hepatology
- Gastroenterology
- Surgical Research
Background:
- Gallstones (cholelithiasis) are more common in patients with cirrhosis.
- The underlying reasons for this association and the impact of gallstones on patient survival are not well understood.
Purpose of the Study:
- To investigate the relationship between gallstones and clinical factors in patients with decompensated cirrhosis.
- To determine if gallstones affect survival in this patient population.
Main Methods:
- Prospective observational study over 8 years.
- Included 90 patients with decompensated cirrhosis.
- Gallstone presence diagnosed via imaging; survival analyzed using log-rank test.
Main Results:
- 40% of patients had gallstones.
- No correlation found between gallstones and patient demographics, cirrhosis etiology, severity, portal hypertension, or biochemical markers.
- Gallstones did not significantly affect patient survival.
Conclusions:
- Cirrhosis is a condition that promotes gallstone formation (lithogenic).
- The specific pathogenetic link between cirrhosis and cholelithiasis requires further investigation.
- Gallstones do not appear to influence survival outcomes in patients with decompensated cirrhosis.
Abstract:
There is general agreement that the prevalence of gallstones in cirrhotics is high (at least twice that in the general population), but the pathogenetic link between cirrhosis and cholelithiasis is still uncertain. The influence of cholelithiasis on survival in cirrhotics is also unknown. During an 8-year period, we observed 90 patients affected by decompensated cirrhosis: 36 of them (40%) turned out by cholecystographic/cholangiographic or ultrasonographic examination to have cholelithiasis. We were not able to demonstrate any correlation between cholelithiasis and sex, age of patients, etiology of cirrhosis, severity of the illness, degree of portal hypertension, previous gastrointestinal bleeding, number of pregnancies, or levels of serum cholesterol, bilirubin, and triglycerides. During the follow-up observation, (range, 1-91 months), 30 patients died. Survival curves analyzed by the log-rank test did not show any difference between patients with or without gallstones. We therefore confirm that cirrhosis is a lithogenic condition, but we were not able to explain the reasons for the close relationship between cholelithiasis and cirrhosis. Gallstones, however, did not affect the survival of these patients.