Cholelithiasis in hepatic cirrhosis: evaluating the role of risk factors.

OBJECTIVE To determine the role of risk factors, which promote cholelithasis in Hepatic Cirrhosis (HC). METHODS A prospective study was conducted on indoor cases with advanced HC. Outpatients with compensated Chronic Liver Disease were used as control. The subjects with history of cholecystectomy and diabetes mellitus were excluded from the study. Conventional ultrasound was used for the detection of gallstones, ascites and portal hypertension. Sonography also furnished pertinent information about the portal vein diameter, size of the spleen, gallbladder wall thickness and echogenecity of the liver. RESULTS The number of registered cases was 206: (age: 30-85 years): 121 (58.7%) males and 85 (41.3%) females. Hepatitis C (HCV) was the cause of HC in 187 (90.88%) cases. Of 50 (24.30%) patients with detectable gallstones, 27(54.00%) were males. We observed correlation of several risk factors with cholelithasis in our patients (n = 50): advanced age: mean 57.3 +/- 9.7 years (100%); prolonged duration of HC: 3.5 years (100%); Child-Pughs' class C: 34 (68%); increased thickness of gallbladder wall: 45 (90%); gross ascites: 39 (78%); splenic enlargement: 17.3 cm (100%); increased portal vein diameter: 13.4mm (100%). The results were statistically significant when compared with the control group (p = < 0.001). CONCLUSION Gallstones tend to occur more frequently in patients with decompensated CLD due to interaction of several risk factors in these patients.