Gallstones and gallbladder wall thickening in patients with cirrhosis: Prevalence and clinical impact

doi:10.12998/wjcc.v14.i1.114043

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World Journal of Clinical Cases

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Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA

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World J Clin Cases. Jan 6, 2026; 14(1): 114043
Published online Jan 6, 2026. doi: 10.12998/wjcc.v14.i1.114043

Gallstones and gallbladder wall thickening in patients with cirrhosis: Prevalence and clinical impact

Alexandra Tsankof, Adonis A Protopapas, Vaia Kyritsi, Christiana Gogou, Maria Kyziroglou, Erofili Papathanasiou, Charikleia Chatzikosma, Aristeidis Michalopoulos, Christos Savopoulos, Andreas N Protopapas, First Propaedeutic Department of Internal Medicine, Aristotle University of Thessaloniki, AHEPA University Hospital, Thessaloniki 54636, Kentrikí Makedonía, Greece

Author contributions: Tsankof A, Protopapas AA, Kyritsi V, Savopoulos C, and Protopapas AN contributed to conception and design; Tsankof A and Protopapas AA involved in drafting of the article; Tsankof A, Protopapas AA, Kyritsi V, Gogou C, Kyziroglou M, Papathanasiou E, Chatzikosma C, Michalopoulos A, Savopoulos C, and Protopapas AN critical revision of the article for important intellectual content and final approval of the article.

Institutional review board statement: The study was approved by the Institutional Review Board of the University Hospital AHEPA, Thessaloniki, Greece.

Informed consent statement: Patients were not required to give informed consent to the study because the analysis used anonymous clinical data that were obtained after each patient agreed to treatment by written consent.

Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.

STROBE statement: The authors have read the STROBE Statement-checklist of items, and the manuscript was prepared and revised according to the STROBE Statement-checklist of items.

Data sharing statement: The data that support the findings of this study are available upon reasonable request from the corresponding author. All data have been anonymized to ensure patient confidentiality and are not publicly available due to institutional regulations.

Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/

Corresponding author: Adonis A Protopapas, First Propaedeutic Department of Internal Medicine, Aristotle University of Thessaloniki, AHEPA University Hospital, Stilponos Kiriakidi 1, Thessaloniki 54636, Kentrikí Makedonía, Greece. adoprot@hotmail.com

Received: September 10, 2025
Revised: October 20, 2025
Accepted: December 22, 2025
Published online: January 6, 2026
Processing time: 117 Days and 12.1 Hours

Abstract

BACKGROUND

Gallstones and gallbladder wall thickening (GBWT) are frequent findings in patients with cirrhosis, reflecting the critical interplay between hepatobiliary dysfunction and portal hypertension.

AIM

To assess the prevalence of gallstones and asymptomatic GBWT in patients with cirrhosis.

METHODS

Hospitalized patients with cirrhosis who had undergone abdominal imaging studies during hospitalization were retrospectively analyzed.

RESULTS

A total of 128 patients were included. The patients had a mean age of 64 ± 12.2 years, were predominantly male (73.4%), and most had decompensated liver cirrhosis (DeCi) (78.1%). Alcohol-associated liver disease (47.7%) and metabolic dysfunction-associated steatohepatitis (16.4%) are the leading causes of cirrhosis. Most patients were classified as Child-Pugh stage B (53.1%), followed by stage C (32%), and stage A (14.8%). A significant percentage of patients had cholelithiasis (39.8%), and DeCi patients were more likely to have gallstones (45%) than compensated patients (21.4%) (P = 0.024). Furthermore, a significant number of patients had asymptomatic GBWT (32.8%), and almost half (42.9%) did not have concurrent cholelithiasis. Patients with DeCi were significantly more likely to have GBWT (39%) than those with compensated disease (10.7%) (P = 0.005). There was no statistical correlation between cirrhosis etiology and cholelithiasis or GBWT.

CONCLUSION

This study underlines the high prevalence of radiologic gallbladder findings in patients with cirrhosis while simultaneously serving as a reminder to clinicians to refrain from accrediting these findings to a diagnosis of acute cholecystitis in the absence of symptoms.

Keywords: Cirrhosis; Gallstones; Gallbladder; Asymptomatic; Decompensation

Core Tip: Gallbladder pathology is encountered in many patients with cirrhosis. The pathophysiology of such findings is not clearly understood, yet they are significantly correlated with the presence of portal hypertension and decompensated cirrhosis. Furthermore, their clinical impact is relatively small. Clinicians should be able to recognize common gallbladder imaging findings in patients with cirrhosis and avoid misdiagnosing these patients with acute biliary disease.