Analysis on the influencing factors of gallbladder wall thickening in Wilson's disease-associated cirrhosis

Abstract

Abstract: Objective To investigate influencing factors of gallbladder wall thickening in patients with Wilson's disease (WD) -associated cirrhosis. Methods A total of 82 patients with WD admitted to our hospital were retrospectively enrolled and they were divided into 3 groups: WD-associated compensated cirrhosis group, WD-associated decompensated cirrhosis group and WD without cirrhosis group. Risk factors for gallbladder wall thickening were analyzed. Results Cholecystopathy was common in patients with WD, especially in patients with WD-associated cirrhosis. Compared to the patients with WD-associated compensated cirrhosis, the rates of gallbladder wall thickening (88.23% vs 42.86%, χ²=25.441, P<0.001), cholecystitis (74.29% vs 64.29%, χ²=10.319, P<0.05) and hydrocholecystis (51.43% vs 21.43%, χ²=9.111, P<0.05) were higher in patients with WD-associated decompensated cirrhosis. Course of disease, total bilirubin, direct bilirubin, serum albumin, cholinesterase, high-density lipoprotein-cholesterol, gallbladder wall roughness and hydrocholecystis were significantly associated with gallbladder wall thickening in patients with WD-associated cirrhosis. Multivariate analysis revealed that inside diameter of portal vein and Child-Pugh C were independently risk factors for gallbladder wall thickening in WD-associated cirrhosis. Conclusion Gallbladder wall thickening is common in patients with WD-associated cirrhosis. Inside diameter of portal vein and Child-Pugh C could be independent risk factors for the development of gallbladder wall thickening.

Key words: Wilson′s disease, Cirrhosis, Gallbladder wall thickening

LI Qi, ZENG A-juan, DING Hui-guo, LI Lei. Analysis on the influencing factors of gallbladder wall thickening in Wilson's disease-associated cirrhosis[J]. Chinese Hepatolgy, 2022, 27(5): 531-535.

References

[1] Sandahl TD, Laursen TL, Munk DE, et al. The prevalence of Wilson’s disease: an update. Hepatology, 2020,71(2):722-732.
[2] Mulligan C, Bronstein JM. Wilson disease: an overview and approach to management. Neurol Clin, 2020,38(2):417-432.
[3] Zhong HJ, Sun HH, Xue LF, et al. Differential hepatic features presenting in Wilson disease-associated cirrhosis and hepatitis B-associated cirrhosis. World J Gastroenterol, 2019,25(3):378-387.
[4] Karrar Z, Patel PJ, Abdurrahman MB. Hydrops of the gall bladder in a child with Wilson′s disease: a rare association. Indian Pediatr,1991,28(7): 791-94.
[5] Chang SK, Chan CL, Yu RQ, et al. Mimicry of acute cholecystitis from Wilson′s disease. Singapore Med J, 2009,50(3): e102-04.
[6] Gucev ZS, Pop-Jordanova N, Calovska V, et al. Acute Gallbladder Hydrops and Arthritis: unusual initial manifestations of Wilson′s Disease (WD): Case Report. Prilozi,2011,32(2): 307-15.
[7] Maudgal DP, Wansbrough-Jones MH, Joseph AE. Gallbladder abnormalities in acute infectious hepatitis. A prospective study. Dig Dis Sci,1984, 29(3): 257-60.
[8] Laudanna AA, Ferreyra NP, Cerri GG, et al. Thickening of the gallbladder wall in alcoholic hepatitis verified by ultrasonographic examination. Its clinical implications. Scand J Gastroenterol,1987,22(5): 521-24.
[9] Saverymuttu SH, Grammatopoulos A, Meanock CI, et al. Gallbladder wall thickening (congestive cholecystopathy) in chronic liver disease: a sign of portal hypertension. Br J Radiol,1990, 63(756): 922-25.
[10] Wang TF, Hwang SJ, Lee EY, et al. Gall-bladder wall thickening in patients with liver cirrhosis. J Gastroenterol Hepatol,1997,12(6): 445-49.
[11] Tsaknakis B, Masri R, Amanzada A, et al. Gall bladder wall thickening as non-invasive screening parameter for esophageal varices - a comparative endoscopic - sonographic study. BMC Gastroenterol,2018,18(1): 123.
[12] 中华医学会神经病学分会帕金森病及运动障碍学组,中华医学会神经病学分会神经遗传病学组. 肝豆状核变性的诊断与治疗指南. 中华神经科杂志, 2008,41(8):566-569.
[13] Acalovschi M. Gallstones in patients with liver cirrhosis: incidence, etiology, clinical and therapeutical aspects. World J Gastroenterol,2014,20(23): 7277-85.
[14] Acalovschi M, Dumitrascu DL, Nicoara CD. Gallbladder contractility in liver cirrhosis: comparative study in patients with and without gallbladder stones. Dig Dis Sci,2004,49(1): 17-24.
[15] Loreno M, Travali S, Bucceri AM, et al. Ultrasonographic study of gallbladder wall thickness and emptying in cirrhotic patients without gallstones. Gastroenterol Res Pract,2009,2009: 683040.
[16] 朱江帆, 单礼成, 陈文华, 等. 肝硬化患者胆囊胆汁脂类、胆红素及金属元素的改变. 中华内科杂志, 1994, 33(11):767-69.
[17] Sakata R, Ueno T, Torimura T, et al. Reduced contractility and histological changes in the gallbladder due to portal hypertension in a hamster cirrhosis model. Digestion,1997,58(5): 444-51.
[18] Fiske CE, Laing FC, Brown TW. Ultrasonographic evidence of gallbladder wall thickening in association with hypoalbuminemia. Radiology,1980,135(3): 713-16.
[19] Son JY, Kim YJ, Park HS, et al. Diffuse gallbladder wall thickening on computed tomography in patients with liver cirrhosis: correlation with clinical and laboratory variables. J Comput Assist Tomogr,2011,35(5): 535-38.
[20] Marshak RH, Linder AE. Intestinal lymphangiectasia and intestinal edema. In; Marshak RH, Linder AE, eds. Radiology of the Small Intestine, 2nd edn. Philadelphia: Saunders, 1976: 72-90.
[21] Zhang QW, Wang Y, Wang J, et al. A non-invasive magnetic resonance imaging-based model predicts portal venous pressure. J Dig Dis,2016,17(3): 175-85.
[22] Butt Z, Hyder Q. Cholelithiasis in hepatic cirrhosis: evaluating the role of risk factors. J Pak Med Assoc,2010, 60(8): 641-44.