Associations Of Gallbladder And Gallstone Parameters With Clinical Outcomes In Patients With Cirrhosis: A Single-Center Retrospective Study

Objective: Gallbladder morphologic changes and gallstones are common in cirrhotic patients,but their associations with outcomes of cirrhotic patients are unclear.Methods: We retrospectively enrolled 206 cirrhotic patients and measured their gallbladder length and width,gallbladder wall thickness,presence of gallstones,and gallstones length and width at axial abdominal contrast-enhanced computed tomography(CT)images.X-tile software was utilized to calculate the optimal cut-off values of these parameters for evaluating survival and hepatic decompensation events in cirrhosis group.Their associations with survival were explored by Cox regression analyses and Kaplan-Meier curve analyses.Their associations with hepatic decompensation events were evaluated by competing risk analyses and Nelson-Aalen cumulative risk curve analyses where death was a competing event.Results: Cirrhotic patients with gallbladder length<72 mm had a significantly higher cumulative survival rate than those≥72 mm(P=0.049 by log-rank test),but gallbladder width,gallbladder wall thickness,presence of gallstones,and gallstones length and width were not significantly associated with survival(P=0.10,P=0.14,P=0.97,P=0.73,and P=0.73 by log-rank tests,respectively).Cirrhotic patients with gallbladder wall thickness<3.4 mm had a significantly lower cumulative rate of hepatic decompensation events than those≥3.4 mm(P=0.02 by Gray’s test),but gallbladder length and width,presence of gallstones,and gallstones length and width were not significantly associated with hepatic decompensation events(P=0.15,P=0.15,P=0.54,P=0.76,and P=0.54 by Gray’s tests,respectively).Conclusion: Changes of gallbladder length and gallbladder wall thickness,rather than gallstones parameters,may be in parallel with long-term outcomes of cirrhotic patients.