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Surgery Service / Hospital General Regional No. 66 - Instituto Mexicano del Seguro Social (Jurez, Mxico)
2
Universidad Autnoma de Ciudad Jurez (Jurez, Mxico).
3
Epidemiology Resident / Universidad de Guadalajara (Guadalajara, Mxico).
Accepted 03 December 2014
Cholelithiasis is the most common biliary pathology, with a prevalence of 14% in Mexico. Although,
obesity is an established risk factor we hypothesized that central obesity is related to severity of
cholelithiasis. We studied patients with symptomatic cholelithiasis, which were underwent to
cholecystectomy. We divided into 3 groups; Group I: patients with uncomplicated cholelithiasis; Group
II: patients with acute cholecystitis, without other complications; and Group III: patients with any
complications than acute cholecystitis. We analyzed age, weight, height, body mass index, waist
circumference, hip circumference, and waist-hip index. We studied 212 patients, included 88 (41.5%)
patients in Group I, 60 (28.3%) in group II, and 64 (30.2%) in group III. We found statistical difference
only in waist circumference (98.6 cm vs 95.3 cm vs 105.3 cm; p=0.001) and waist-hip index (0.91
vs0.89vs 0.96; p=<0.001). Our results suggest that central obesity and waist-hip index could play an
important role in patients with severe gallstone-related complications.
Key words: Cholelithiasis, cholecystectomy, gallbladder, gallstones, obesity.
INTRODUCTION
The cholelithiasis and its related complications are one of
the most common digestive diseases in the world (Gtzky
et al., 2013).This disease is considered a public health
problem in Mexico with a crude prevalence of 14.3% in
autopsies, 8.5% for males and 20.4% for females
(Mndez-Snchez et al., 1993).The pathogenesis of
cholelithiasis is multifactorial, it have a strong relation
with obesity (Dittrick et al., 2005), diabetes, insulin
resistance, and dyslipidemia.
Variables
Age (years)
Weight (kg)
Height (cm)
2
BMI (kg/m )
Waist (cm)
Hip (cm)
Waist-Hip index
Total
n= 212
37.1
75.8
155
31.6
99.7
108.5
0.92
9.8
15.4
6.4
6.3
14.9
12.5
0.07
Group I
n= 88
38.5
10.3
76.1
15.7
154.9
5.7
31.2
5.8
98.6
13.9
108.6
12.5
0.91
0.08
Group II
n= 60
37.8
10.7
73.7
19
154.4
6.6
31
8.1
95.3
16.1
106.9
15.5
0.89
0.07
Group III
n= 64
34.5
7.6
77.4
10.5
154.4
6.9
32.6
4.8
105.3
13.3
109.7
8.7
0.96
0.06
p
0.036
0.41
0.25
0.31
0.001
0.47
<0.001
Complication
Biliary pancreatitis
Mucocele
Empyema
Choledocolithiasis
Cholangitis
Cases
20
16
12
12
4
Percentage
9.4
7.5
5.7
5.7
1.9
RESULTS
We review 326 cases of cholecystectomy and included
212 cases during January to December of 2013.We
divided by groups and included 88 (41.5%) patients in
Group I (biliary colic), 60 (28.3%) in Group II (acute
cholecystitis), and 64 (30.2%) in Group III (any
complication than acute cholecystitis). The main
gallstone-related
complications
were
pancreatitis,
followed by mucocele, empyema, choledocolithiasis and
cholangitis. Number of cases and percentages are
showed in Table 2.
The comparative between groups, there were not
statistical difference in variables age, weigh, height, BMI,
and hip circumference. However, there were a statistical
differences in mean of waist circumference (98.6 cm vs
95.3 cm vs 105.3 cm; p=0.001), and mean of waist-hip
index (0.91 vs0.89vs 0.96; p=<0.001) (Table 1).
All patients (complicated and non-complicated) were
treated and discharged by health improvement and
followed by outpatient consult.
REFERENCES