Abstract
For decades, one well-known risk factor for the development of gallbladder stones has been hypothyroidism. Recent studies have interestingly reported that the risk in particular for common bile duct (CBD) stones increases in clinical and subclinical hypothyroidism. There are multiple factors that may contribute to the formation and/or accumulation of CBD stones in hypothyroid patients, including decreased liver cholesterol metabolism, diminished bile secretion, and reduced sphincter of Oddi relaxation. This paper focuses on the mechanisms possibly underlying the association between hypothyroidism and CBD stones. The authors conclude that when treating patients with CBD stones or microlithiasis, clinicians should be aware of the possible hypothyroid background.
Highlights
Several factors affecting bile content and bile flow are involved in the complex pathogenesis of gallstones
The higher prevalence of hypothyroidism in common bile duct (CBD) stone patients compared to gallbladder stone patients suggests that changes in the cholesterol metabolism, or bile excretion rate, but changes in the function of the sphincter of Oddi (SO) that may underline the association between CBD stones and hypothyroidism
It remains to be investigated whether hypothyroid individuals who have had their gallbladder removed are at an increased risk to develop CBD stones when compared to euthyroid individuals in the same situation
Summary
Several factors affecting bile content and bile flow are involved in the complex pathogenesis of gallstones. The risk for gallbladder stones [1, 2], and the risk for common bile duct (CBD) stones in particular is increased [3,4,5]. Impaired liver cholesterol metabolism [6], diminished bile secretion [7], and reduced sphincter of Oddi (SO) relaxation [8, 9] may contribute to the formation and/or accumulation of CBD stones in hypothyroid patients. In this paper the possible mechanisms underlying the association between hypothyroidism and CBD stones are being discussed
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