title: Gallbladder disease in patients with primary sclerosing cholangitis.
abstract: OBJECTIVE
  Gallbladder abnormalities may be part of the spectrum in primary sclerosing cholangitis (PSC). The aim of the present study was to evaluate the occurrence and prognostic importance of gallbladder abnormalities in patients with PSC.
  
  
  METHODS
  Presence of gallbladder abnormalities was assessed in 286 patients with PSC treated at the Liver Unit, Karolinska University Hospital, Huddinge, between 1970 and 2005.
  
  
  RESULTS
  One or more gallbladder abnormalities were found in 41% of the patients. Gallstones were found in 25% and cholecystitis in 25%. Cholecystitis among patients with extrahepatic involvement of PSC (30% (65/214)) was significantly higher than among those with intrahepatic involvement (9% (6/70)) (P<0.0001). A gallbladder mass lesion with a mean size of 21 (+/-9) mm (S.D.) was found in 18 (6%) patients, in 56% (10/18) of whom it constituted gallbladder carcinoma. In 9 patients without a gallbladder mass lesion, histological re-evaluation disclosed epithelial dysplasia of the gallbladder.
  
  
  CONCLUSIONS
  Gallbladder disease is common in patients with PSC. Dysplasia and carcinoma are commonly found in gallbladder epithelium, suggesting that regular examination of the gallbladder in PSC patients could be of value for early detection of a gallbladder mass lesion. Cholecystectomy is recommended when such a lesion is detected, regardless of its size.
authors.affiliation: Department of Gastroenterology and Hepatology, Karolinska University Hospital, Huddinge, Karolinska Institute, 141 86 Stockholm, Sweden. karouk.said@ki.se
authors.forename: Karouk
authors.initials: K
authors.lastname: Said
authors.forename: Hans
authors.initials: H
authors.lastname: Glaumann
authors.forename: Annika
authors.initials: A
authors.lastname: Bergquist
mesh_terms: D000328:Adult; D002760:Cholangiopancreatography, Endoscopic Retrograde; D049448:Cholangiopancreatography, Magnetic Resonance; D015209:Cholangitis, Sclerosing / Q000150:complications* / Q000175:diagnosis / Q000601:surgery; D002763:Cholecystectomy; D003937:Diagnosis, Differential; D005260:Female; D005500:Follow-Up Studies; D005705:Gallbladder Diseases / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology*; D006801:Humans; D015994:Incidence; D008297:Male; D011379:Prognosis; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed