Cholecystectomy-Associated Complications in Kidney Transplant Recipients Compared With the General Population.

Autor: Rinaldis A; Gastroenterology Surgery Department, Hospital do Rim, Universidade Federal de São Paulo (UNIFESP), São Paulo, Brazil., Matavelli FA; Gastroenterology Surgery Department, Hospital do Rim, Universidade Federal de São Paulo (UNIFESP), São Paulo, Brazil., Lourenço LG; Gastroenterology Surgery Department, Hospital do Rim, Universidade Federal de São Paulo (UNIFESP), São Paulo, Brazil., Foresto RD; Nephrology Department, Hospital do Rim, Universidade Federal de São Paulo (UNIFESP), São Paulo, Brazil., Silva HT Jr; Nephrology Department, Hospital do Rim, Universidade Federal de São Paulo (UNIFESP), São Paulo, Brazil. Electronic address: heliotedesco@medfarm.com.br., Pestana JM; Nephrology Department, Hospital do Rim, Universidade Federal de São Paulo (UNIFESP), São Paulo, Brazil.
Jazyk: angličtina
Zdroj: Transplantation proceedings [Transplant Proc] 2021 Sep; Vol. 53 (7), pp. 2291-2297. Date of Electronic Publication: 2021 Aug 16.
DOI: 10.1016/j.transproceed.2021.07.029
Abstrakt: Cholelithiasis is one of the most prevalent diseases in the general population. Among kidney transplant (KT) recipients, atypical clinical presentation may delay the diagnosis and proper treatment. This single-center retrospective cohort study compared cholelithiasis clinical presentation and cholecystectomy-associated complications in 230 KT recipients and in 172 members of the general population. KT recipients had a higher proportion of men, comorbidities, biliary pancreatitis, choledocholithiasis, and acute cholecystitis clinical presentations than the general population. KT recipients presented higher American Society of Anesthesiologists scores and higher rates of emergency surgeries (15.7% vs 9.9%, P = .091), conversion (5.7% vs 1.2%, P = .019), drainage (7.8% vs 2.3%, P = .016), postoperative complications (10% vs 4.7%, P = .047), and longer hospital length of stay (1 vs 1 days, interquartile range, 2 vs 0 days; P < .001). There were 5 deaths, all of which occurred in KT recipients. History of diabetes mellitus, renal function, and surgical conversion were independent risk factors associated with postoperative complications. Male sex and level of renal function were independent risk factors associated with postoperative acute cholecystitis. KT was an independent risk factor associated with postoperative choledocholithiasis (adjusted odds ratio, 5.89; 95% confidence interval, 3.03-15.66) and pancreatitis (adjusted odds ratio, 6.89; 95% confidence interval, 2.99-11.61). In conclusion, KT recipients with cholelithiasis have an increased risk for clinical and surgical complications compared with the general population.
(Copyright © 2021 Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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