Cirrhosis and Alcoholism as Pathogenetic Factors in Piqment Gallstone Formation

Abstract

The association of cirrhosis with pigment gallstones has been noted in numerous autopsy studies. However a direct relationship between alcoholism and pigment cholelithiasis has not been previously demonstrated. We have classified 123 cholecystectomy patients according to stone type and correlated the resulting categories with hepatic morphology, drinking history, and hematological data. Pigment stones were found in 79% of biopsy-verified cirrhotic patients but in only 26% of noncirrhotics. In patients without cirrhosis a positive history of alcoholism was found associated with pigment gallstones more often than with cholesterol or mixed stones (36% vs. 10%). Similarly, the mean red cell volume (MCV), a sensitive marker of alcoholism, was significantly increased in patients with pigment stones (93.6 mu 3 vs. 89.6 mu 3). We conclude that both cirrhosis and alcoholism predispose to pigment gallstone formation and that the effect of alcoholism may occur independent of cirrhosis. This suggests that the apparent association of cirrhosis with pigment stones may, in fact, result from a direct effect of long-term ethanol ingestion on red blood cells, liver, or bile.

Prevalence of gallbladder disease among persons with hepatitis C virus infection in the United States†

“…2,3,16 Cirrhosis has also been shown to be an important risk factor for the development of GBD. [4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20][21][22] Although cholesterol stones are the most common type of gallstone in the general population, pigment stones are the most prevalent *Odds ratios are for the comparison of HCV-positive persons to those that were HCV negative. †For both men and women, fully adjusted odds ratios were adjusted for age, race/ethnicity, body mass index, waist-to-hip circumference ratio, highest completed year of education, poverty income ratio, breakfast frequency, voluntary weight loss in the previous 12 months, monthly leisure physical activity, serum total cholesterol, presence of diabetes, alcohol use, and tobacco use.…”

“…1,3 Furthermore, the annual direct and indirect costs of GBD in the United States in 2000 was approximately $6.5 billion, making it the second most costly digestive disease. 1 Although cirrhosis is a well-documented risk factor for the formation of gallstones, [4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20][21][22] little is known about the prevalence of GBD in persons with hepatitis C virus (HCV) infection. In addition to GBD, HCV infection is also an important public health problem in the United States and is a leading cause of chronic liver disease and cirrhosis.…”

Laparoscopic cholecystectomy and cirrhosis: A case-control study of outcomes

“…[1][2][3][4] When patients with cirrhosis with gallstones become symptomatic or develop complications, consideration of surgical intervention is warranted. However, the risks may be greater than in the healthy population.…”

Cholecystolithotomy Combined Armillarisin A versus Cholecystectomy in Cirrhotic Portal Hypertension Patients with Symptomatic Cholelithiasis

“…The prevalence of cholelithiasis in cirrhosis can be up to 29% (7). Reduction in gallbladder emptying and motility, caused by hypersplenism, increased intravascular hemolysis and increased levels of estrogen were the main reasons for the higher incidence of cholelithiasis in cirrhotic PHT patients (8).…”