SNFGE SNFGE
 
Thématique :
- MICI
Originalité :
Très original
Solidité :
Très solide
Doit faire évoluer notre pratique :
Immédiatement
 
 
Nom du veilleur :
Professeur Vered ABITBOL-SELINGER
Coup de coeur :
 
 
The American Journal of Gastroenterology
  2017/03  
 
  2017 Mar;112(3):473-478.  
  doi: 10.1038/ajg.2016.564  
 
  Increased Risk of Gallstone Disease Following Colectomy for Ulcerative Colitis  
 
  Mark-Christensen A, Brandsborg S, Laurberg S, Johansen N, Pachler JH, Thorlacius-Ussing O, Kjær MD, Qvist N, Preisler L, Hillingsø J, Rosenberg J, Jepsen P  
  https://www.ncbi.nlm.nih.gov/pubmed/28117363  
 
 

Abstract

OBJECTIVES:

Biochemical studies suggest that patients who have had a colectomy or restorative proctocolectomy with ileal pouch-anal anastomosis (IPAA) are at an increased risk of developing gallstone disease, but epidemiological studies are lacking. We evaluated the risk of gallstone disease following colectomy and IPAA.

METHODS:

Individuals who had a colectomy were identified from a national cohort of patients with ulcerative colitis (UC), and controls without colectomy were sampled from within the same cohort, matching on gender, calendar year, and year of birth. We used Cox regression to examine the effect of colectomy on the hazard rates of gallstone disease and cholecystectomy, adjusting for alcoholism, stroke, chronic obstructive pulmonary disease, cancer, cardiac disease, diabetes mellitus, hypothyroidism, hyperlipidemia, cirrhosis, obesity, renal failure, and transient ischemic attacks. The effect of an IPAA was determined for patients who had colectomy by including the procedure as a time-dependent variable.

RESULTS:

We identified 4548 patients and matched these to 44 372 controls without colectomy. During a median follow-up of 11.9 years, 1963 patients were hospitalized for gallstone disease. Patients who had a colectomy were at an increased risk (adjusted hazard ratio (HR)=1.63 (1.39-1.91)), and sensitivity analyses of the risk of undergoing cholecystectomy revealed a similar association (adjusted HR=1.55 (1.22-1.98)). An IPAA did not affect the risk of developing gallstones among patients who had a colectomy (adjusted HR=1.03 (0.77-1.37)).

CONCLUSION:

The risk of gallstone disease increases following colectomy for UC. 

 

 
Question posée
 
Les patients ayant eu une colectomie ou coloproctectomie avec anastomose iléo-anale (AIA) pour RCH sont-ils à risque de maladie lithiasique biliaire?
 
Question posée
 
Oui, les patients ayant une colectomie pour RCH avaient un risque augmenté de lithiase biliaire symptomatique ou compliquée (RR=1,63 (1,39–1,91)) et de cholecystectomie (RR=1,55 (1,22–1,98)). Les patients colectomisés avec ou sans AIA n’avait pas un risque différent.
 
Commentaires

Etude bien menée utilisant la base de données Nationale Danoise évaluant une large population de patients ayant eu une colectomie pour RCH (N=4548) appariée avec 44372 contrôles sans colectomie, ayant identifié 1963 patients hospitalisés pour lithiase biliaire symptomatique ou compliquée pendant une durée de 11,9 ans.

 
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