COLELITIASIS EN PACIENTES DESPUÉS DE CIRUGÍA BARIÁTRICA: REVISIÓN DE LA LITERATURA
DOI:
https://doi.org/10.66104/k7tssa54Palabras clave:
obesidad; colelitiasis; cirugía bariátrica.Resumen
La obesidad se caracteriza por la acumulación excesiva de grasa corporal capaz de comprometer la salud, y se clasifica según el índice de masa corporal (IMC) en eutrofia (18–24,9 kg/m²), sobrepeso (25–29,9 kg/m²) y obesidad grado I a III (≥30 kg/m²). Desde 1975, su prevalencia mundial se ha triplicado, afectando a más de 1.000 millones de personas. La cirugía bariátrica constituye una alternativa eficaz para pacientes refractarios a tratamientos conservadores. La enfermedad biliar no neoplásica, incluida la colelitiasis, es una complicación frecuente en el postoperatorio de la cirugía bariátrica, resultante de múltiples mecanismos litogénicos, como la rápida pérdida de peso, el aumento de la liberación de colesterol y lípidos desde los adipocitos y la reducción del IMC preoperatorio ≥25%. El objetivo de este estudio fue analizar, mediante una revisión de la literatura, la relación entre la enfermedad biliar no neoplásica y la obesidad, enfatizando los factores de riesgo, los mecanismos fisiopatológicos y la indicación de colecistectomía concomitante a la cirugía bariátrica. Se seleccionaron 20 artículos publicados a partir de 2003, obtenidos de las bases de datos PubMed, SciELO y LILACS, utilizando los descriptores bariatric, cholelithiasis y obesity. La incidencia de colelitiasis post-bariátrica varió entre 1,4% y 55,5%, con mayor riesgo en mujeres, pacientes con rápida pérdida de peso, multiparidad o uso de anticonceptivos orales. Entre los factores protectores se incluyen la edad avanzada, el uso de estatinas y la profilaxis con ácido ursodesoxicólico. La colelitiasis tiende a ocurrir durante los primeros seis meses posteriores a la cirugía, siendo más frecuente tras el bypass gástrico. La colecistectomía concomitante se considera segura, estando especialmente indicada en pacientes con cálculos biliares preexistentes.
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Derechos de autor 2026 GEYZA CAROLINE OLIVEIRA PINTO PINTO, GUTEMBERG FERNANDES DE ARAÚJO
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