Pattern of Cholelithiasis and Cholecystitis among Obese Patients

Abstract

Introduction: Obesity is a major health problem in western society with rapidly increasing prevalence in most countries. The healthcare burden of obesity is far reaching but many of the consequences are yet to be fully understood. While there is a perception that obesity negatively impacts on health and stone formation in gall bladder there is conflicting evidence for this. Aims & Objectives: To assess whether obesity impacts on the blood cholesterol level which leads to dislipidaemia and gall stone formation. To identify whether dislipidaemia causes cholelithiasis and cholecystitis among obese patient. Methods: Between 1st December, 2018 and 31thMay, 2019, patients admitted in dept of surgery at Shaheed Ziaur Rahman Medical College Hospital in Bogura, Bangladesh were enrolled. Following informed consent, BMI was assessed. High risk patients and complications were identified according to established criteria. Patients were grouped according to BMI categories as Normal, overweight, Obese grade-I and Obese grade-II. Various disease of gall bladder including stone formation and its complications were analysed on all obese patients treated at Shaheed Ziaur Rahman Medical College Hospital using a SQL database. Results: Total 59 people were available and consented for this study. 09 patients were excluded; 4 patient were obese but no cholelithiasis or cholecystitis, 3 patients were not agree to investigations and 2 patients declined study). The remaining 50 patients, 29 females and 21 males, included for analysis. The median age was 48 with a range from 18-55. A literature review found evidence of increased risk of dyslipidemia which induce stone formation in GB and inflammation of gall bladder associated with obesity. Conclusion: It is an important issue that obesity is increasing in our new generations. This study should take into account for the future health care researcher. This study has summarized the current body of literature and added to it by demonstrating in our cohort that obese patients were at increased risk of formation of gallstones. I have also provided the evidence that patients with increased BMI with cholelithiasis or cholecystitis or other comorbidities are associated with significantly greater cost to the healthcare system.