Blas AR, Montoya RJ, Gaytán FOF

Language: Spanish
References: 27
Page: 30-34
PDF size: 299.86 Kb.

ABSTRACT

Introduction: Cholelithiasis is one of the major health problems that afflict the adult population in the world and Mexico has a prevalence of 20% in men and 40 to 50% in women. It occurs frequently in patients with overweight and diabetes mellitus. In this condition involving the detergent effect of bile acids and the cytotoxic effect of lysolecithin, the hydrolysis product of bile lecithin, subsequently bacterial inflammation is implanted in the injured bladder causing various clinical symptoms, if left unchecked bacterial growth may produce suppurative cholecystitis that causes pain in the right upper quadrant caused by the acute inflammation of the gallbladder wall. The etiology may be secondary to stasis, bacterial infection or ischemia, among other factors. Cholecystectomy has been for more than a century the treatment of choice in symptomatic patients. Moreover, there is scarse medical literature about the presence of this gallbladder condition in patients undergoing obesity surgery or the clinical course of patients with prior vesicular disease and handling during and after the bariatric procedure. In practice concomitantly bariatric surgery and cholecystectomy has been the subject of controversy. However, meta-analysis recommends avoiding making preventive cholecystectomy during "Bypass" surgery, being a choice procedure only in obese patients with symptomatic cholelithiasis. Material and methods: This study included 55 patients with overweight from the list addressed by bariatric surgery, patients 30 to 60 years, 41 female and 14 male. Results: The weight of the patients had the following distribution: 2 (4%) patients of 50-70 kg; weight range of 71-90 kg reported 1 (2%); of 91-110 kg 17 (31%); with a range of 111-130 kg were reported 20 (36%) patients; of 131-150 kg were reported 9 (16%) patients; in the range of 151-170 kg 3 (5%) and 171-190 kg reported 3 (5%) patients. The body mass index (BMI) of the 55 patients was reported: BMI range 30-40, 9 (16%) patients; 41 -50 BMI found in 33 (60%) patients; from 51-60 BMI was reported in 11 (20%) patients, 61-70 BMI, 1 (2%) and only 1 (2%) patient reported 70-80BMI. Preoperative diagnosis: From 55 patients, 37 of them (67%) correspond to patients with obesity grade III, 7 patients (13%) corresponding to super obesity, 6 patients (11%) diagnosed with super- super obesity and 5 patients (9%) had a preoperative diagnosis of obesity Grade II. Conclusion: The incidence of vesicular disease and its complications in patients undergoing obesity surgery was 3.6% and in those diagnosed with this comorbidity it was possible to perform both surgeries in a concomitant way without added risk factors.

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