The Study Of Ultrasonic Typing And Mechanism Of Gallbladder Wall Change In Patients With Hepatic Cirrhosis

Objective According to the data of patients with liver cirrhosis:â‘ To investigate the gallbladder wall changes in different types of decompensated cirrhosis patients.(2)To investigate the relationship between gallbladder wall-typing, the main portal vein and right portal vein hemodynamics in patients with liver cirrhosis.â‘¢To investigate the relationship between the double-walled gallbladders and hypoproteinemia on ultrasound images and laboratory test.Methods Collecting clinical data about cirihosis patients from department of infedtious diseases of our hospital in February 2008 to March 2009,and combining data of two-dimensional ultrasound with low or high frequency and color ultrasonic.â‘ According to the different etiology, the 78 cases with decompensated cirrhosis were divided into posthepatic cirrhosis of chronic hepatitis B 48 cases, posthepatic cirrhosis of chronic hepatitis C 15 cases, posthepatic alcoholic cirrhosis 10 cases, autoimmune cirrhosis 2 cases, drug-induced liver cirrhosis 3 cases. The thickness and typing of gallbladder wall, the Vpv and Dpv were examined in 78 cases with cirrhosis.â‘¡The main portal vein and right portal vein hemodynamics and the thickness of gallbladder wall were examined in 69 patients with cirrhosis and 30 normal subjects. According to the gallbladder wall-typing,69 patients with liver cirrhosis were divided into"not thickened","simple thickening" and "bilateral"groups.â‘¢To measure the thickness and observe the change of gallbladder wall in 75 cases with liver cirrhosis and 43 cases with NS. According to the level of ALB, we divided the liver cirrhosis cases into three groups, the ALB level more than 35 g/L group, between 30 g/L and 35 g/L group and less than 30 g/L group, respectively. Meanwhile, the level of ALB of all patients was detected.Resultsâ‘ Different etiology of liver cirrhosis can cause the same changes of gallbladder wall, and there was no significant difference among changes.â‘¡There was statistical difference in thickness of gallbladder wall among "not thickened", "simple thickening" and "bilateral" 3 groups. Statistical difference of the Dpv was found among the groups (P<0.01), except between "not thickened" and "simple thic- kening" group. Statistical difference of the Vpv was found between "simple thickening group" and normal group, as well as between "bilateral group" and the normal group (P<0.01). Statistical differences of the Qpv were detected between "bilateral group" and other 2 groups and normal group (P<0.05). No statistical difference of Drpv and Qrpv were found among all groups. The Vrpv of "bilateral group" was statistical different with that of the normal group and the "simple thickening group"(P<0.05). There was positive correlation between the gallbladder wall thickness and Dpv (r=0.886, P<0.01). No statistical difference of Qrpv/Qpv existed between the patients with liver cirrhosis and the normal subjects (P>0.05).â‘¢The double-walled gallbladders was observed in 75 cases with liver cirrhosis and 43 cases with NS. The incidence of double-walled gallbladders in NS group is 76.92%, and in liver cirrohosis group is 54.69% and there was no statistically difference between two groups. The ALB level has statistically significant difference, however. In the three groups of liver cirrhosis the incidence of double-walled gallbladders is different from NS group. The ALB level is lower, the incidence of bilateral gallbladder wall is higher. There was statistically significant difference among the different groups. While the thickness of double-walled gallbladders has statistically difference between the group with the ALB level more than 35 g/L and other groups.Conclusionâ‘ Different causes of cirrhosis can lead to the same changes of the gallbladder wall.â‘¡The gallbladder wall-typing has no correlation with the right portal vein hemodynamics, but is related with the main portal vein hemodynamics. The bilateral and the thickness of gallbladder wall can indirectly reflect the hemodynamic changes of main portal vein. Obstruction to flow of cystic vein is not the main hemodynamic cause for the gallbladder wall changes in patients with liver cirrhosis and portal hypertension cause, indicating that there may be some intrinsic mechanisms of this phenomenon.â‘¢The hypoproteinemia could be a dominant potential mechanism to cause double-walled gallbladders in cirrhosis. With decrease of the ALB level, the incidence of double-walled gallbladders is increasing. The double-walled gallbladders might predict the level of ALB by gallbladder ultrasound.