Prevention of gall stone in celiac patients and the gallbladder ejection fraction evaluation

Introduction:The aim of our study was to determine the frequency of gallbladder, liver, biliary tract, pancreas and spleen pathologies along with gallbladder ejection fraction in patients with cheliac disease. Materialand method:A prospective study included 50 celiac patients under treatment and 50 healthy controls. Demographic data, blood pressure, body mass index, waist circumference measurements, as well as whole blood and biochemistry results of the patient and control groups were recorded. All cases were evaluated with transabdominal ultrasonography, and liver, bile ducts, gall bladder, portal vein, hepatic veins, pancreas, spleen and paraaortic region were evaluated. In order to measure the gallbladder ejection fraction, basal gallbladder long diameter and transverse diameter were measured, then milk was drunk and the bladder long diameter and transverse diameter were measured again one hour later. Ejection fraction: basal long diameter x transverse diameter2 – post-milk long diameter x transverse diameter2 / basal long diameter x transverse diameter2 x100. Results: Between Celiac and control groups, body mass index (22 vs 24.2 ; p<0.01), waist circumference (80.2 cm vs 84.9 cm; p<0.05), mean hemoglobin (13.1 g/dLvs 14.4 g/dL, p=0.002), AST (24.2 U/dLvs 20.7 U/dL, p=0.01), ALP (81.9 U/dLvs 58 U/dL, p=0.003), triglyceride (92.3 mg/dLvs 134.9 mg/dL, p=0.02), and ferritin (30 A significant difference was found in terms of mg/dLvs 53.9 mg/dL, p=0.001) (respectively) levels. Although gallstones were not detected in any of the celiac patients, they were detected in two (4%) patients in the control group. There was no difference between the groups in terms of hepatic steatosis, pancreatic steatosis, pancreatic body thickness, portal vein diameter, splenic vein diameter, gallbladder ejection fraction, and abdominal lymphadenopathy frequency. The spleen long axis (91.9 mm vs 100.7 mm; p<0.01) and spleen index (19.8 mm2vs 22.9 mm2 , p<0.001) were found to be significantly lower in Celiac patients compared to the control group. Conclusion:In our study, no significant pathology was found in celiac patients under treatment, except for low morphometric measurement values, laboratory abnormalities suggestive of malabsorption, and findings suggestive of hyposplenism. Keywords: celiac disease, gallbladder, gallstone, hyposplenism, ejection fraction.