Comparative study of gallbladder motility in patients with chronic HCV hepatitis and with HCV cirrhosis.

AIM: To compare gallbladder (GB) emptying in patients with chronic hepatitis C and in those with HCV related cirrhosis.

METHOD: 20 patients with HCV chronic hepatitis and 20 patients with HCV cirrhosis Child class A were enrolled in the study. The control group included 20 hospitalized patients free of liver disease. We excluded subjects with GB lithiasis or GB anomalies, and those with obesity and diabetes mellitus. In all patients, the following GB variables were measured: fasting volume (FV), minimal residual volume (RV), ejection fraction (EF), wall thickness and area under the emptying curve (AUC). The statistical analysis was performed using the Man-Whitney and Kruskal-Wallis tests and the Pearson correlation coefficient.

RESULTS

In cirrhotic patients, the fasting GB volume (35.62 +/- 4.45cm3) and the residual volume (18.46 +/- 3.27cm3) were larger than in controls: 27.12 +/- 5.38cm3 and 7.28 +/- 3.15cm3, respectively (p < 0.00001). The GB EF was reduced in cirrhotics as compared to controls (p < 0.00001). The patients with HCV chronic hepatitis had a residual volume larger (14.18 +/- 6.11cm3 vs 7.28 +/- 3.15cm3; p = 0.0129), and an EF lower than controls (53.4 +/- 14.15cm3 vs. 72.76 +/- 9.96cm3) (p = 0.0005). The GB emptying curves showed a significantly slower emptying in cirrhotic and chronic hepatitis patients as compared to controls. We found a significant negative correlation in chronic hepatitis patients between EF, on one hand, and overweight and abdominal circumference, on the other. The GB wall was thicker in cirrhotics (5.1 +/- 0.32mm) as compared to controls (2.32 +/- 0.27mm) (p < 0.00001), and also in chronic hepatitis patients as compared to controls (p < 0.0001).

CONCLUSION

A decrease in GB motility was present both in patients with HCV related cirrhosis and in those with chronic HCV hepatitis. This may be, partly, caused by an increase in GB wall thickness, and might be a risk factor for the development of gallstones.