Gallstone disease (GSD) and nonalcoholic fatty liver disease (NAFLD) share common risk factors for their occurrence. Evidence points to a potential association between these lifestyle-induced diseases. Liver biopsy is the standard diagnostic tool for NAFLD.

A recent prospective observational study evaluated the prevalence of asymptomatic NAFLD or NASH in liver biopsy. The study also assessed the association of hypercholesterolemia with NAFLD in patients undergoing laparoscopic cholecystectomy (LC).

The study included patients undergoing LC for symptomatic gallstones in the Department of General Surgery, Post Graduate Institute of Medical Education and Research, Chandigarh, India, between July 1, 2013 and December 31, 2014. All the participants were subjected to ultrasonography (USG) and were tested for serum triglycerides (TG), cholesterol, low density lipoprotein cholesterol (LDL-C), and high-density lipoprotein cholesterol (HDL-C). A wedge liver biopsy was obtained from free edge of the right liver lobe during LC and the biopsy specimens were assessed by a single pathologist.

In all, 101 patients were included in the study. Dyslipidemia was noted in 49.50%. No association was found between NAFLD and serum cholesterol, TG or LDL-C. Liver biopsy confirmed NAFLD in 21.8% of the patients but none had fibrosis or cirrhosis.

Liver biopsy during LC is a promising way of diagnosing the disease at an early and reversible stage. Furthermore, it is feasible, safe and cost effective.

Source: Singh K, Dahiya D, Kaman L, Das A. Prevalence of non-alcoholic fatty liver disease and hypercholesterolemia in patients with gallstone disease undergoing laparoscopic cholecystectomy. Pol Przegl Chir. 2019 Nov 15;92(1):18-22.