Excess Body Weight and Gallstone Disease

Abstract

<b><i>Background:</i></b> Approximately one fifth of adults are diagnosed with gallstones worldwide. Of these, around 25% develop gallstone disease (indicated by the presence of symptoms) and undergo cholecystectomy. <b><i>Summary:</i></b> The risk of gallstones is influenced by a combination of genetic and lifestyle factors, such as excess body weight. In fact, body mass has been demonstrated to be a major risk factor for symptomatic gallstones. Rapid weight loss can also initiate a prolithogenic state and further increase the likelihood of either gallstone formation or existing gallstones becoming symptomatic; however, sensible weight loss strategies can mitigate this risk. This review discusses the role of excess body weight and the risk of gallstone disease, as well as the options available for the prevention of symptomatic gallstones. <b><i>Key Messages:</i></b> Healthy weight loss diets combined with regular physical activity can promote successful weight loss and weight maintenance and reduce the risk of gallstones. Should rapid weight loss be required for health reasons or be expected, e.g., after bariatric surgery, prophylactic ursodeoxycholic acid during the period of weight reduction has been demonstrated to reduce the incidence of gallstones formation or symptomatic gallstone occurrence. The recent German guidelines on gallstones recommend simultaneous cholecystectomy during bariatric surgery but only for those with preexisting symptomatic stones.

Effect of ursodeoxycholic acid on gallstone formation after bariatric surgery: An updated meta‐analysis

“…Cholecystectomy performed during surgery increases the risk of postoperative complications as well as the duration of the procedure, whereas cholecystectomy after surgery increases the incidence of adverse events (14,15). Ursodeoxycholic acid (UDCA) has been recommended as a treatment for gallstones because of its characteristics, including convenience, safety, and tolerability; nevertheless, there are certain controversies about its optimal management, such as the optimal dose, course of treatment, and applicability (16)(17)(18)(19).…”

Prevalence and risk factor of cholelithiasis after laparoscopic sleeve gastrectomy among Hail population, Saudi Arabia

“…Many studies link the sudden loss of weight to an increased risk of gallstone development following sleeve gastrectomy (Stokes et al, 2021;Haal et al, 2022;Aldriweesh et al, 2020). Rapid weight loss was found to be the only risk factor for post-LSG gallbladder illness in a recent Saudi study.…”

Therapeutic efficacy evaluation of the reference drug ursodeoxycholic acid and its analogues in the biliary sludge dissolution: a meta-analysis

“…В настоящее время желчнокаменная болезнь (ЖКБ) является широко распространенным заболеванием пищеварительной системы и частой причиной госпитализаций, ассоциированных с высокими экономическими затратами на лечение [1]. Согласно некоторым данным глобальная частота выявления ЖКБ у взрослых достигает 20% и имеет тенденцию к росту [1][2][3]. Патогенез образования камней в желчном пузыре детерминируется сложным многофакторным процессом с участием гендерных, генетических, средовых факторов риска, определенных паттернов образа жизни и диеты, а также сопутствующих заболеваний [4][5][6].…”

“…Патогенез образования камней в желчном пузыре детерминируется сложным многофакторным процессом с участием гендерных, генетических, средовых факторов риска, определенных паттернов образа жизни и диеты, а также сопутствующих заболеваний [4][5][6]. Клиническое течение ЖКБ варьирует от бессимптомного носительства до неосложненного симптоматического заболевания с болевыми приступами и осложненного течения, требующего оперативного вмешательства [2,4,6]. В когортных исследованиях с длительным периодом наблюдения (7-20 лет) частота развития осложненных форм ЖКБ варьирует от 3 до 8% [6].…”