Sonographic study of gall bladder function in patients with chronic liver disease and its relation to gall stone formation

ABSTRACT

Gall stones occur in about 30% of patients with cirrhosis, gall stones are often asymptomatic in liver cirrhosis, and the hypothesis of diminished gall bladder contractility in chronic liver disease may explain the high frequency of asymptomatic gall bladder stones. The present study was designed to evaluate ultrasonographically the alteration of gall bladder contractility and whether there is a relation between this alteration and cholelithiasis in chronic liver disease. Twenty selected male patients with hepatosplenic involvement in addition to 20 healthy male control of age matched they were divided into 3 groups Group 1 Chronic liver disease [CLD] with gall stones [10 patients]. Group 2 CLD without gall stones [10 patients]. Group 3 Healthy controls [20]. Ultrasonographic examination was performed, fasting and one hour after a standard fatty meal, G.B. volume was calculated as follow Vol. = Lx Wx Hx TI/6 The results showed Significant increase in the fasting volume of the gall bladder when comparing group 1 and control P<0.01 Significant increase in post prandial volume comparing G1 and G2 P<0.05. Highly significant increase in postprandial volume comparing G1 and control P<0.01. Significant increase in post prandial volume comparing G2 and control P<0.05. It is concluded from this study that delayed emptying of the gall bladder is a risk factor for gall bladder stone formation in cirrhotic patients, together with other risk factors as increased age, severity of cirrhosis and increased levels of serum triglycerides, and that ultrasound is an easy, non-invasive tool for the evaluation of the gall bladder motor function