The Incidence of Gallstone Complications in Patients with Cirrhosis

About one-third of patients with cirrhosis have gallstones. Gallstones in these patients are often asymptomatic and discovered incidentally, and only 1–2% per year will develop complications. We aimed to assess the frequency of gallstone complications in Egyptian patients with cirrhosis and compare them to gallstone complications in those without cirrhosis.

Our study included 120 patients with first-time discovered gallstones. They were selected from patients admitted to the outpatient clinic or the Tropical Medicine Department of Zagazig University, Egypt. They were classified into two groups. The first group comprised 60 patients with cirrhosis with gallstones and the second group comprised 60 healthy individuals with gallstones. Risk factors of gallstones were assessed. Upon admission, all patients underwent a thorough history and clinical examination. Moreover, liver function tests and pelviabdominal ultrasound were done and triglyceride and amylase levels were measured to confirm the presence of gallstones. They were followed up for five years to assess the frequency of gallstone complications.

The group with cirrhosis had significantly lower gallstone complications than the non-cirrhotic group (8% vs. 41%, p <0.001) as regard the overall complications after 5 years of follow-up. We found that there was a significant difference regarding each complication separately. Acute cholecystitis was (5% vs. 16.7%, p = 0.03). Acute pancreatitis was (1.6% vs. 13.3%, p = 0.01). Obstructive jaundice was (1.6% vs. 11.7%, p = 0.02).

Our study revealed that the frequency of gallstones complications in patients with cirrhosis was much lower than patients without cirrhosis with gallstones after 5 years of follow-up.