HBV as one of the causes for development of cholelithiasis

The aim of this study was to identify the influence of HBV on gall bladder and to establish necessity and terms of preventive measures. For this reason we have examined 58 patients, passed through cholecystectomy and 142 patients with B hepatitis. Patients of this group were followed up during 18 months. In the first group presence HBsAg in the gall bladder tissue was identified using immunoferment analysis and immunofluorescent testing. In all cases the blood was tested for specific markers (HBsAg, Anti-HB-cor antibodies of G and M classes). In the second group 75 patients were investigated prospectively. Observation using ultrasound was performed to find out the changes of gall bladder and bile. In this group preventive measures against gallstone formation were performed. 67 patients were investigated retrospectively and prevention was not performed among them. In 10 cases of cholecystectomy (17,2%) out of 58, HBsAg in the gall bladder tissue was identified both, with immunoferment analysis and immunofluorescent testing. The ultrasound examination revealed morpho-functional changes of gall bladder and bile in the acute stage of hepatitis B and also in following period. There were no cases of development of gallstones in the group where preventive measures using dietary fiber-rich food "Margi" were conducted, in the second group, where such measures have not been performed, gallstones developed in 5 patients (7,46%) out of 67, during 6-18 months after the acute B hepatitis. This results allow us to conclude, that cholecystopathogenic influence of HBV leads to the morpho-functional changes of gall bladder. This fact must be assessed as a risk factor for development of cholelithiasis and confirms necessity of early longlasting preventive measures.