Asymptomatic Cholelithiasis Occurrence in Patients of Kidney Transplantation List
André T. De Brito1, André M. Siqueira1, Luiz S. Azevedo2, José Eduardo M. Cunha1, José Jukemura*1
1Gastroenterology, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil; 2Urology, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
Introduction: There is no agreement in literature about the most correct treatment for patients with asymptomatic gallstones in kidney transplantation list. Some authors suggested routine screening to gallstones for patients who are awaiting a kidney graft and cholecystectomy is indicated to all the candidates with cholelithiasis. Meanwhile, the occurrence of asymptomatic cholelithiasis in brasilian`s kidney transplantation population is not well known.OBJECTIVE: This study aims to determine asymptomatic cholelithiasis occurrence in patients who are in the kidney transplantation list of the Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo.
Methods: We evaluated the 342 patients who were in kidney transplantation list of Hospital das Clínicas de São Paulo in the moment of the study. The candidates to a transplant were screened to gallstones and asked about previous cholecystectomy and symptoms related to cholelithiasis. All patients were submitted to total abdomen ultrasound. Data about symptoms, sex, age, body mass index, number of pregnancies, previous digestive system surgeries, hepatic diseases, hemodialysis time and laboratory exams were collected,.
Results: The occurrence of biliary disease was 11,9% (41/342), which of these 29 (8,4%) patients had cholelithiasis and 12 (3,5%) had been cholecystectomized before being included in transplant list. All cholecystectomized patients were symptomatic (biliar colic pain, acute cholecystitis, jaundice or pancreatitis) at the time of the surgery. Among the evaluated, 41,5% (17/41) were or remained symptomatic.
Conclusion: The occurrence of cholelithiasis in kidney transplantation list patients is similar to the general population, however an important part is symptomatic.