Abstract
The two most important pancreatic and biliary surgical emergencies are acute cholecystitis and acute pancreatitis. This chapter will evaluate the strong association between obesity and the incidence and severity of these two diseases. Their treatment is not different in obese patients if compared with the non-obese population; however, the peculiarity of this subset of patients is represented by their “fragility” and, consequently, by their higher risk of developing severe forms of these diseases. It is mandatory for the surgeons to keep in mind this condition, in order to make an early diagnosis and to correctly treat these two pathologies.
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References
Huffman JL, Schenker S. Acute acalculous cholecystitis: a review. Clin Gastroenterol Hepatol. 2010;8:15–22.
Ingraham AM, Cohen ME, Ko CY, Hall BL. A current profile and assessment of North American cholecystectomy: results from the American College of Surgeons National Surgical Quality Improvement Program. J Am Coll Surg. 2010;211:176–86.
Maclure KM, Hayes KC, Colditz GA, et al. Weight, diet, and the risk of symptomatic gallstones in middle-aged women. N Engl J Med. 1989;321:563–9.
Freeman JB, Meyer PD, Printen KJ, et al. Analysis of gallbladder bile in morbid obesity. Am J Surg. 1975;129:163–6.
Portincasa P, Di Ciaula A, Palmieri V, et al. Effects of cholestyramine on gallbladder and gastric emptying in obese and lean subjects. Eur J Clin Investig. 1995;25:746–53.
Shiffman ML, Sugerman HJ, Kellum JM, Moore EW. Changes in gallbladder bile composition following gallstone formation and weight reduction. Gastroenterology. 1992;103:214–21.
Cl L, Fan ST, Lai EC, et al. Factors affecting conversion of laparoscopic cholecystectomy to open surgery. Arch Surg. 1996;131:98–101.
Afaneh C, Abelson J, Rich BS, et al. Obesity does not increase morbidity of laparoscopic cholecystectomy. J Surg Res. 2014;190:491–7.
Neylan CJ, Damrauer SM, Kelx RR, et al. The role of body mass index class in cholecystectomy after acute cholecystitis: an American College of Surgeons National Surgical Quality Improvement Program analysis. Surgery. 2016;160:699–707.
Gatsoulis N, Koulas S, Kiparos G, et al. Laparoscopic cholecystectomy in obese and nonobese patients. Obes Surg. 1999;9:459–61.
Morel P, Hagen ME, Bucher P, et al. Robotic single-port cholecystectomy using a new platform: initial clinical experience. J Gastrointest Surg. 2011;15:2182–6.
Svoboda S, Waqish TR, Wilson A, et al. Robotic single-site cholecystectomy in the obese: outcomes from a single institution. Surg Obes Relat Dis. 2015;11:882–7.
Chandio A, Timmons S, Majeed A, et al. Factors influencing the successful completion of laparoscopic cholecystectomy. JSLS. 2009;13:581–6.
Paajanen H, Kakela P, Suuronen S, et al. Impact of obesity and associated diseases on outcome after laparoscopic cholecystectomy. Surg Laparosc Endosc Percutan Tech. 2012;22:509–13.
Simopoulos C, Polychronnidis A, Botaitis S, et al. Laparoscopic cholecystectomy in obese patients. Obes Surg. 2005;15:243–6.
Lipman JM, Claridge JA, Haridas M, et al. Preoperative findings predict conversion from laparoscopic to open cholecystectomy. Surgery. 2007;142:556–63.
Farkas DT, Moradi D, Moaddei D, et al. The impact of body mass index on outcomes after laparoscopic cholecystectomy. Surg Endosc. 2012;26:964–9.
Giger UF, Michel JM, Optiz I, et al. Risk factors for perioperative complications in patients undergoing laparoscopic cholecystectomy: analysis of 22,953 consecutive cases from the Swiss Association of Laparoscopic and Thoracoscopic Surgery database. J Am Coll Surg. 2006;203:723–8.
Hirose K, Shore AD, Wick EC, et al. Pay for obesity? Pay-for-performance metrics neglect increased complication rates and cost for obese patients. J Gastrointest Surg. 2011;15:1128–35.
Banks PA, Freeman ML, Practice Parameters Committee of the American College of Gastroenterology. Practice guidelines in acute pancreatitis. Am J Gastroenterol. 2006;101:2379–400.
Yadav D, Lowenfels AB. The epidemiology of pancreatitis and pancreatic cancer. Gastroenterology. 2013;144:1253–61.
Banks PA, Bollen TL, Dervenis C, et al. Classification of acute pancreatitis - 2012: revision of the Atlanta classification and definitions by international consensus. Gut. 2013;62:102–11.
Whitcomb DC. Clinical practice. Acute pancreatitis. N Engl J Med. 2006;354:2142–50.
Andersson R, Andersson B, Haraldsen P, et al. Incidence, management and recurrence rate of acute pancreatitis. Scand J Gastroenterol. 2004;39:891–4.
Lindkvist B, Appelros S, Manjer J, et al. A prospective cohort study of smoking in acute pancreatitis. Pancreatology. 2008;8:63–70.
Peery AF, Crockett SD, Barritt AS, et al. Burden of gastrointestinal, liver, and pancreatic disease in the United States. Gastroenterology. 2015;149:1731–41.
Sadr-Azodi O, Orsini N, Andren-Sandberg, Wolk A. Abdominal and total adiposity and the risk of acute pancreatitis: a population-based prospective cohort study. Am J Gastroenterol. 2013;108:133–9.
Saisho Y, Butler AE, Meier JJ, et al. Pancreas volumes in human from birth to age one hundred taking into account sex, obesity, and the presence of type-e diabetes. Clin Anat. 2007;20:933–42.
Acharya C, Cline RA, Jaligama D, et al. Fibrosis reduces severity of acute-on-chronic pancreatitis in humans. Gastroenterology. 2013;145:466–75.
Acharya C, Navina S, Singh VP. Role of pancreatic fat in the outcomes of pancreatitis. Pancreatology. 2014;14:403–8.
Lee YH, Pratley RE. The evolving role of inflammation in obesity and the metabolic syndrome. Curr Diab Rep. 2005;5:70–5.
Chen S, Xiong G, Wu S. Is obesity an indicator of complication and mortality in acute pancreatitis? An updated meta-analysis. J Dig Dis. 2012;13:244–51.
Krishna SG, Hinton A, Oza V, et al. Morbid obesity is associated with adverse clinical outcomes in acute pancreatitis: a propensity-matched study. Am J Gastroenterol. 2015;110:1608–19.
Shin KY, Lee WS, Chung DW, et al. Influence of obesity on the severity and clinical outcome of acute pancreatitis. Gut Liver. 2011;5:335–9.
De Waele B, Vanmierlo B, van Niewwenhove Y, et al. Impact of body overweight and class I, II and III obesity on the outcome of acute biliary pancreatitis. Pancreas. 2006;32:343–5.
Martinez J, Johnson CD, Sanchez-Paya J, et al. Obesity is a definitive risk factor of severity and mortality in acute pancreatitis: an updated meta-analysis. Pancreatology. 2006;6:206–9.
Hong S, Qiwen B, Ying J, et al. Body mass index and the risk and prognosis of acute pancreatitis: a meta-analysis. Eur J Gastroenterol Hepatol. 2001;23:1136–43.
Wang S, Li S, Feng Q, et al. Overweight is an additional prognostic factor in acute pancreatitis: a meta-analysis. Pancreatology. 2011;11:92–8.
Papachristou GI, Papachristou DJ, Avula H, et al. Obesity increases the severity of acute pancreatitis: performance of APACHE-O score and correlation with the inflammatory response. Pancreatology. 2006;6:279–85.
Johnson CD, Toh SK, Campbell MJ. Combination of APACHE-II score and an obesity score (APACHE-O) for the prediction of severe acute pancreatitis. Pancreatology. 2004;4:1–6.
Osvaldt AB, Viero P, Borges de Costa MS, et al. Evaluation of Ranson, Glasgow, APACHE-II and APACHE-O criteria to predict severity in acute biliary pancreatitis. Int Surg. 2001;86:158–61.
Premukmar R, Phillips AR, Petrov MS, et al. The clinical relevance of obesity in acute pancreatitis: targeted systematic reviews. Pancreatology. 2014;15:25–33.
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Nappo, G., Zerbi, A., Montorsi, M. (2020). Pancreatic and Biliary Emergencies. In: Foschi, D., Navarra, G. (eds) Emergency Surgery in Obese Patients. Updates in Surgery. Springer, Cham. https://doi.org/10.1007/978-3-030-17305-0_9
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DOI: https://doi.org/10.1007/978-3-030-17305-0_9
Publisher Name: Springer, Cham
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