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Arch Intern Med. 1999;159:49-52
"Close Relation Between Cirrhosis and Gallstones:
Cross-sectional and Longitudinal Survey"
Dario Conte, MD; Mirella Fraquelli, MD; Fabio Fornari, MD; Lucia
Lodi, MD; Paolo Bodini, MD; Luigi Buscarini, MD
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.
Patients and 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.
Conclusion:
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.
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