AUTHOR=Gao Xuejin , Zhang Li , Wang Siwen , Xiao Yaqin , Song Deshuai , Zhou Da , Wang Xinying 

TITLE=Prevalence, Risk Factors, and Complications of Cholelithiasis in Adults With Short Bowel Syndrome: A Longitudinal Cohort Study

JOURNAL=Frontiers in Nutrition

VOLUME=Volume 8 - 2021

YEAR=2021

URL=https://www.frontiersin.org/journals/nutrition/articles/10.3389/fnut.2021.762240

DOI=10.3389/fnut.2021.762240

ISSN=2296-861X

ABSTRACT=Background: Patients with short bowel syndrome (SBS) are at a high risk of cholestasis or cholelithiasis. This study aimed to determine the incidence, risk factors, and clinical consequences of cholelithiasis in adults with SBS over an extended period.
Methods: All eligible adults diagnosed with SBS and admitted to a tertiary hospital center between January 2010 and December 2019 were retrospectively identified from the hospital records database. Kaplan-Meier analysis was used to estimate the cumulative incidence of SBS during the 10-year period. For assessment the risk factors for cholelithiasis, we used multivariate Cox proportional hazards model with estimation of hazard ratio (HR) with 95% confidence intervals (95 %CI).
Results: This study enrolled 345 eligible patients with SBS. Kaplan-Meier analysis revealed that 72 patients (20.9%) developed cholelithiasis during the 10-year observation period. In multivariate analyses using the Cox proportional hazard model revealed that the remnant jejunum (HR=2.163; 95% confidence interval [CI]: 1.156–4.047, p=0.016) and parenteral nutrition dependence (HR=1.783; 95% CI: 1.077–2.952, p=0.025) were independent risk factors for cholelithiasis in adults with SBS. Twenty-eight patients developed symptoms and/or complications in the cholelithiasis group. Proportions of acute cholecystitis or cholangitis and acute pancreatitis were significantly increased in the cholelithiasis group compared with the non-cholelithiasis group (31.9% versus [vs.] 7.7%, p<0.01; and 6.9% vs. 1.1%, p=0.003, respectively).
Conclusion: Because of the adverse clinical consequences of cholelithiasis, adult patients with SBS should be closely monitored, and preventive interventions should be considered.
Clinical Trial Registration: ClinicalTrials.gov (Identifier: NCT04867538).