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 pa tients with cirrhosis. Objective: To evaluate the frequency of gallstones and related risk factors in a large series of patients with cirrhosis. Patients and Methods: The cross-sectional study involved 1010 patients with cirrhosis related to alcohol abuse, chronic viral infection, or miscellane ous causes (42%, 48%, and 10%, respectively) in Child class A, B, or C (48% , 36%, and 16%, respectively). In the longitudinal study gallstone developm ent was monitored ultrasonographically in 618 patients free of gallstones a t enrollment. Results: The overall prevalence of gallstone(s) was 29.5% and increased sig nificantly with age without differences according to sex or cause of cirrho sis. 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). D uring 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. Mul tivariate analysis showed that Child class (hazard ratio, 2.8 for class C v s class A and 1.8 for class B vs class A; P = .002 and P = .001, respective ly) and high-body mass index (hazard ratio, 1.31; P = .04) carried a signif icantly greater risk of gallstone formation. Conclusion: Cirrhosis per se represents a major risk factor for gallstones whose prevalence and incidence were far higher than those reported in a gen eral population from the same area.