title: Obesity and the risk and prognosis of gallstone disease and pancreatitis.
abstract: Obesity is a risk factor for the formation of cholesterol gallstones and exposes patients to increased risk of gallstone-related complications and cholecystectomy. Rapid weight loss achieved by very low calorie diets or bariatric surgery is also a risk factor for cholelithiasis in obese patients, and therapy should take into account the higher prevalence of gallstones, the possibility of more frequent complications and the need for prophylactic treatment with oral ursodeoxycholic acid during weight loss. Obesity is also frequent in children and adolescents, and the burden of cholesterol cholelithiasis is increasing in this population. The chance to develop acute pancreatitis and the severity of the disease are higher in obese subjects because of specific pathogenic factors, including supersaturated bile and crystal formation, rapid weight loss, and visceral obesity. All health policies aimed at reducing the incidence of obesity worldwide will decrease the incidence of gallstones and gallstone-related complications. The pathophysiological scenarios and the therapeutic implications for obesity, gallstone disease, and pancreatitis are discussed.
authors.affiliation: Residency Programme in Internal Medicine, University of Bari Medical School, 70124 Bari, Italy. Electronic address: leonilde.bonfrate@uniba.it.
authors.forename: Leonilde
authors.initials: L
authors.lastname: Bonfrate
authors.affiliation: Department of Internal Medicine, Division of Gastroenterology and Hepatology, Saint Louis University School of Medicine, St. Louis, MO 63104, USA. Electronic address: dwang15@slu.edu.
authors.forename: David Q-H
authors.initials: DQ
authors.lastname: Wang
authors.affiliation: Department of Emergency and Organ Transplants, Section of Endocrinology, Andrology and Metabolic Diseases, University of Bari Medical School, 70124 Bari, Italy. Electronic address: gabriella.garruti@uniba.it.
authors.forename: Gabriella
authors.initials: G
authors.lastname: Garruti
authors.affiliation: Department of Biomedical Sciences and Human Oncology, Clinica Medica "A. Murri", University of Bari Medical School, Piazza Giulio Cesare 11, 70124 Bari, Italy. Electronic address: piero.portincasa@uniba.it.
authors.forename: Piero
authors.initials: P
authors.lastname: Portincasa
mesh_terms: D002763:Cholecystectomy; D002769:Cholelithiasis / Q000209:etiology* / Q000601:surgery; D006801:Humans; D009765:Obesity / Q000150:complications*; D010195:Pancreatitis / Q000209:etiology* / Q000601:surgery; D011379:Prognosis; D012307:Risk Factors
keywords: Bariatric surgery; Cholecystectomy; Cholesterol; Gallbladder motility; Metabolic syndrome; Rapid weight loss