[Gallstones in liver cirrhosis]

The prevalence of gallstones in cirrhotic patients has been found to be higher than in the general population, by at least twofold. Of this increment, the majority of stones are of the pigment type in the gallbladder. The composition of black stone is unique because of the large fraction of unconjugated bilirubin, which is present as calcium bilirubinate or in an undefined polymeric form. There is little doubt that biliary surgery is hazardous in cirrhotic patients. Elective surgery for symptomatic Child A and B patients would normally be warranted. For Child C patients with life-threatened cholecystitis or cholangitis, every type of medical treatment should be attempted. After considering the bleeding tendency or ascites, percutaneous transhepatic gallbladder drainage or endoscopic sphincterotomy is considered to be one of the treatments.