Colectomy Increases Risk of Gallstones in Patients with Ulcerative Colitis, Study Suggests

Colectomy Increases Risk of Gallstones in Patients with Ulcerative Colitis, Study Suggests

The risk of gallstones increases after patients with ulcerative colitis have undergone a colectomy, according to the results of a Danish study.

The study, “Increased Risk of Gallstone Disease Following Colectomy for Ulcerative Colitis,” was published in The American Journal of Gastroenterology.

Ulcerative colitis (UC) is a long-term condition that results in inflammation and ulcers in the colon and rectum. Patients may require a colectomy (a surgical procedure to remove all or part of the colon). Following surgery, bowel continuity may be restored through a procedure called restorative proctectomy with ileal pouch-anal anastomosis (IPAA).

This surgical procedure aims to facilitate the absorption of non-soluble elements, such as bile acids. Malabsorption of bile acids resulting from a colectomy can promote supersaturation of biliary cholesterol, which may lead to an increased risk of symptomatic gallstones (hard deposits in the gallbladder).

To evaluate the risk of gallstone disease following colectomy and IPAA, Mark-Christensen, MD, with Aarhus University Hospital, and colleagues used a Danish national registry to identify 4,548 UC patients who had a colectomy and 44,372 matched controls with UC who did not have a colectomy. Over a median follow-up of 11.9 years, 1,963 patients were hospitalized for gallstones.

After adjusting for a variety of clinical parameters, including history of alcoholism, stroke, chronic obstructive pulmonary disease, cancer and cardiac disease, the researchers found that patients who had a colectomy were at an increased risk of developing gallstones, compared with those who had not undergone surgery.

Results from a sensitivity risk analysis of undergoing a cholecystectomy (surgical removal of the gall bladder) showed that a colectomy also increased the risk for that surgery.

Having had an IPAA, however, did not affect the risk of developing gallstones among patients who had a colectomy.

“In conclusion, the risk of developing gallstones increased following colectomy for UC, and concurrent or subsequent restorative proctectomy with IPAA did not add to this risk,” the researchers wrote.

More studies are needed, the scientists suggested, to identify high-risk patients in order to minimize the likelihood of gallstones after colectomy.