title: Presence of concomitant inflammatory bowel disease is associated with an increased risk of postcholecystectomy complications.
abstract: BACKGROUND
  Surgery in patients with inflammatory bowel disease (IBD) is often associated with complications. The aim of our study was to evaluate whether concomitant IBD was associated with an increased risk of postcholecystectomy complications.
  
  
  METHODS
  The study group consisted of 82 consecutive IBD patients who underwent cholecystectomy from January 2001 to October 2010. The control group included 296 cholecystectomy patients without IBD who were randomly selected from the cholecystectomy database. Variables were analyzed by univariate and multivariate analyses.
  
  
  RESULTS
  There were no significant differences in age, gender, body mass index, presence of gallstones/common bile duct stones, indication for cholecystectomy, and postoperative mortality between the study and control groups. More patients in the study group had postoperative complications than in the control group (17.1% vs. 6.8%, P = 0.005). On multivariate analysis, the presence of concomitant IBD was independently associated with an increased risk for postoperative complications (odds ratio [OR] = 4.64; 95% confidence interval [CI], 1.63-13.20, P = 0.004) after adjusting for age, the presence of cirrhosis, diabetes, body mass index, the use of corticosteroids, immunomodulators, total parental nutrition, or biologics, the presence of primary sclerosing cholangitis (PSC), acute or chronic cholecystitis, cholelithiasis, or prior abdominal surgeries, and indication for surgery (elective vs. emergent).
  
  
  CONCLUSIONS
  IBD patients undergoing cholecystectomy have a significantly increased risk of postoperative complications. Although further studies are warranted to clarify the reason for these differences, caution should be taken to determine the need and timing of cholecystectomy in IBD patients.
authors: Department of Gastroenterology and Hepatology, Digestive Disease Institute, Cleveland Clinic Foundation, Cleveland, Ohio 44195, USA.
authors: Udayakumar
authors: U
authors: Navaneethan
authors: Anuja
authors: A
authors: Choure
authors: Preethi G K
authors: PG
authors: Venkatesh
authors: Jeffrey
authors: J
authors: Hammel
authors: Jingmei
authors: J
authors: Lin
authors: John R
authors: JR
authors: Goldblum
authors: Elena
authors: E
authors: Manilich
authors: Ravi P
authors: RP
authors: Kiran
authors: Feza H
authors: FH
authors: Remzi
authors: Bo
authors: B
authors: Shen
mesh_terms: D016022:Case-Control Studies; D002763:Cholecystectomy / Q000009:adverse effects*; D005260:Female; D042882:Gallstones / Q000150:complications / Q000601:surgery; D006801:Humans; D015212:Inflammatory Bowel Diseases / Q000150:complications* / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D011379:Prognosis; D012307:Risk Factors