Results: Gallbladder was enlarged in 35 patients (89 [86-106] mL) and within normal

range in 42 (41 [35-47] mL). Patients with enlarged gallbladders did not significantly differ from others regarding gender (65% vs. 66% males), median age (43 vs. 42 years), time from diagnosis (5 vs. 5.5 years), body mass index (21.6 vs. 23.7), associated inflammatory bowel disease (71% vs. 50%), UDCA treatment (89% vs. 90%), other MRI features including cystic abnormalities (8.5% vs. 12%), clinical or histological parameters of liver disease (Mayo risk score of −0.18 [−0.45-0.27] vs. −0.005 [−0.63-0.56]). Notably, malignancy was less frequent in the group with enlarged gallbladder, occurring in 2 (5.7%) vs. 11 (26.2%) patients with normal gallbladder size (P=0.029). Colorectal cancer in particular was 6.7-fold less frequent, occurring in 1 (2.8%) Akt inhibitor vs. 8 (19%) patients (P=0.037, OR=6.7 [0.9- 354])). In patients with enlarged gallbladder, the serum concentrations of secondary bile acids were lower than in other patients (1.6 [1.3-1.9] vs. 2.5 [2-3.1]

μmol/L, P=0.0004). This was true for deoxycholic acid (0.7 [0.5-1] vs. 2.2 [1-6-3] μmol/L, P=0.0001), a secondary bile acid known to promote colon carcinogenesis. Patients in this group also had higher concentrations of primary bile acids (10.5 [6.6-16.7] vs. 4.3 [3.5-5.3] μmol/L, P=0.0001) selleck chemicals and of UDCA (44.0 [29.4-52] vs. 27.2 [14.6-31.1] μmol/L, P=0.001). Furthermore, they had higher serum concentrations of the gallbladder-relaxing hormone FGF19 (211.6 [168.6-234.6] vs. 88.6 [72.7-121.6] pg/mL, P=0.0001), 4��8C which concentration was correlated with gallbladder volume (R2=0.46, P=0.001) Conclusion: Gallbladder is enlarged in approximately half of PSC patients, which can be caused by increased FGF19 levels, and which is associated with a lack of secondary bile acids, enhanced UDCA enrichment and a lower prevalence of colorectal cancer, consistent with protective properties of gallbladder enlargement in PSC. Disclosures: Olivier Chazouillères – Consulting: APTALIS, MAYOLY-SPINDLER The following

people have nothing to disclose: Mourad Aissou, Lionel Arrivé, Dominique Rainteau, Sara Lemoinne, Astrid Donald D. Kemgang Fankem, Delphine Firrincieli, Nicolas Chignard, Christophe Corpechot, Chantal Housset [Background and Aims] Although it is well established that treatment with ursodeoxycholic acid (UDCA) improves long-term outcome in patients with primary biliary cirrhosis (PBC), it is still uncertain whether “early” PBC, with normal or low ALP levels and at early histological stages, would benefit from UDCA treatment. In Japan nationwide surveys for PBC have been performed every three year since 1980, and so far clinical data of 7,376 cases have been accumulated. In the current study we examined the long-term outcome of asymptomatic PBC patients with normal or low ALP and at early histological stages in whom UDCA treatment was not initiated.