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Acute cholecystitis after colectomy for ulcerative colitis.

D García Picazo1, E Bermúdez Rodríguez, J M Moreno Resina

  • 1General and Digestive Surgery Service, General Hospital of Albacete, Spain. mmoralesp@nexo.es

Revista Espanola De Enfermedades Digestivas
|September 14, 2000
PubMed
Summary

Colectomy for ulcerative colitis significantly increases the risk of postoperative acute cholecystitis, particularly in emergency cases. Prophylactic cholecystectomy may be considered due to cholecystitis-related mortality.

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Area of Science:

  • Gastroenterology
  • Surgical Oncology
  • Hepatology

Background:

  • Ulcerative colitis is frequently associated with hepatobiliary diseases.
  • The risk of postoperative complications following colectomy in ulcerative colitis patients requires further investigation.

Purpose of the Study:

  • To determine if colectomy for ulcerative colitis increases the risk of postoperative cholecystitis compared to colectomy for other conditions.
  • To evaluate the incidence of acute cholecystitis in patients undergoing colectomy.

Main Methods:

  • Retrospective study of 53 subtotal or total colectomies performed between 1990 and 1998.
  • Patients were divided into two groups: Group I (ulcerative colitis) and Group II (other indications).
  • Comparison of postoperative acute cholecystitis rates between the groups.

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Main Results:

  • 21% of ulcerative colitis patients (Group I) required reoperation for acute cholecystitis, versus 0% in Group II.
  • Emergency surgery was more common in Group I (94.5%) than in Group II (38.2%).
  • Parenteral nutrition and diabetes were not found to be influential factors.

Conclusions:

  • Acute cholecystitis is a common complication after colectomy for ulcerative colitis, especially in emergency settings.
  • The high mortality associated with cholecystitis suggests prophylactic cholecystectomy may be warranted.
  • Further research with larger sample sizes is needed to confirm these findings.