Close relation between cirrhosis and gallstones: cross-sectional and longitudinal survey.
BACKGROUND
Increased gallstone prevalence and incidence in cirrhosis have already been reported in different series, including a limited number of patients with cirrhosis.


OBJECTIVE
To evaluate the frequency of gallstones and related risk factors in a large series of patients with cirrhosis.


METHODS
The cross-sectional study involved 1010 patients with cirrhosis related to alcohol abuse, chronic viral infection, or miscellaneous causes (42%, 48%, and 10%, respectively) in Child class A, B, or C (48%, 36%, and 16%, respectively). In the longitudinal study gallstone development was monitored ultrasonographically in 618 patients free of gallstones at enrollment.


RESULTS
The overall prevalence of gallstone(s) was 29.5% and increased significantly with age without differences according to sex or cause of cirrhosis. Multiple logistic regression analysis showed that only Child classes B and C were significantly related to a higher risk of gallstone (odds ratio, 1.63 for class C vs class A and 1.91 for class B vs class A; P = .001). During a mean+/-SD follow-up of 50 months+/-9 months, 141 (22.8%) of 618 patients developed gallstone(s), with an estimated cumulative probability of 6.5%, 18.6%, 28.2%, and 40.9% at 2, 4, 6, and 8 years, respectively. Multivariate analysis showed that Child class (hazard ratio, 2.8 for class C vs class A and 1.8 for class B vs class A; P = .002 and P = .001, respectively) and high-body mass index (hazard ratio, 1.31; P = .04) carried a significantly greater risk of gallstone formation.


CONCLUSIONS
Cirrhosis per se represents a major risk factor for gallstones whose prevalence and incidence were far higher than those reported in a general population from the same area.
Conte
D
D
IRCCS Maggiore Hospital, Milan, Italy. Gastrbia@imiucca.csi.unimi.it
Fraquelli
M
M
Fornari
F
F
Lodi
L
L
Bodini
P
P
Buscarini
L
L
D000328:Adult; D017677:Age Distribution; D000368:Aged; D002769:Cholelithiasis / Q000000981:diagnostic imaging / Q000453:epidemiology* / Q000209:etiology*; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D015994:Incidence; D007558:Italy / Q000453:epidemiology; D008103:Liver Cirrhosis / Q000150:complications*; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D015995:Prevalence; D012306:Risk; D012307:Risk Factors; D017678:Sex Distribution; D014463:Ultrasonography