Tsankof A, Protopapas AA, Kyritsi V, Gogou C, Kyziroglou M, Papathanasiou E, Chatzikosma C, Michalopoulos A, Savopoulos C, Protopapas AN. Gallstones and gallbladder wall thickening in patients with cirrhosis: Prevalence and clinical impact. World J Clin Cases 2026; 14(1): 114043 [PMID: 41551687 DOI: 10.12998/wjcc.v14.i1.114043]
Corresponding Author of This Article
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
Research Domain of This Article
Gastroenterology & Hepatology
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Observational Study
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Jan 6, 2026 (publication date) through Feb 23, 2026
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Publication Name
World Journal of Clinical Cases
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2307-8960
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Tsankof A, Protopapas AA, Kyritsi V, Gogou C, Kyziroglou M, Papathanasiou E, Chatzikosma C, Michalopoulos A, Savopoulos C, Protopapas AN. Gallstones and gallbladder wall thickening in patients with cirrhosis: Prevalence and clinical impact. World J Clin Cases 2026; 14(1): 114043 [PMID: 41551687 DOI: 10.12998/wjcc.v14.i1.114043]
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
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.
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 14 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.
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.
