Impact of Rapid Weight Reduction on Risk of Cholelithiasis after Bariatric Surgery

Oliveira, Carlos Iglézias Brandão de; Chaim, Élinton Adami; Silva, Benedito Borges da

doi:10.1381/096089203322190862

Cited by 177 publications

(70 citation statements)

References 12 publications

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“…In addition to obesity as a well-known factor for development of cholelithiasis, rapid weight loss and altered GB function after bariatric surgery is associated with an even greater risk (2,3,9,11). Within the first two years after bariatric surgery, up to 50% of the patients develop gallstones or biliary sludge, although most of them are asymptomatic (11,12). Therefore, cholecystectomy is often required in obese people, but timing still remains controversial (13,14).…”

Section: Discussionmentioning

confidence: 99%

Is concomitant cholecystectomy with laparoscopic sleeve gastrectomy safe?

Coşkun¹,

Hasbahçeci²,

Bozkurt³

et al. 2015

Turk J Gastroenterol

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Background/Aims: To study the effect of selective concomitant cholecystectomy (SCC) on laparoscopic sleeve gastrectomy (LSG). Materials and Methods: A retrospective case-control study of 16 morbidly obese patients treated with concomitant LSG as the primary bariatric surgery and SCC for proven gallbladder (GB) pathology (Group A) between November 2010 and February 2013 was performed. Randomly selected 32 patients who underwent laparoscopic sleeve gastrectomy was the control group (Group B). Results: A total of 48 patients with a mean age of 35.5±10.7 years were included. Demographic data of groups were similar except that there were more female patients in the Group A (p=0.036). Mean body mass index (kg/ m2) was 51.1±5.6 and 50.9±5.4 in Groups A and B, respectively (p=0.894). The mean operative time for patients with and without cholecystectomy was 157.2±40 and 95.72±6.2 min, respectively (p=0.001). Cholecystectomy resulted in an additional mean operative time of 49.1±27.9 min without any specific complication. There was no statistical difference with regard to overall morbidity (p=0.316) and the length of hospital stay (p=0.528) between groups. Conclusion: Although an increase in operative time may be an important issue, SCC can be performed on all patients with proven GB pathology during LSG without an increase in morbidity or length of hospital stay.

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Section: Discussionmentioning

confidence: 99%

Is concomitant cholecystectomy with laparoscopic sleeve gastrectomy safe?

Coşkun¹,

Hasbahçeci²,

Bozkurt³

et al. 2015

Turk J Gastroenterol

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show abstract

“…Following bariatric surgery, especially Roux-en-Y gastric bypass (RYGB), the frequency of gallstone formation increases as compared to the normal population due to rapid weight loss (3,4). Hepatic supersaturation of bile with cholesterol, gallbladder stasis, and increased concentration of mucin within bile are possible causes (5).…”

Section: Introductionmentioning

confidence: 99%

The evaluation of gallstone formation in patients undergoing Roux-en -Y gastric bypass due to morbid obesity

Karadeniz¹,

Görgün²,

Kara³

2014

UCD

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Objective: This study aimed to evaluate gallstone formation, prophylactic and selective cholecystectomy and the effectiveness of ursodeoxycholic acid treatment following laparoscopic Roux-en -Y gastric bypass (LRYGB) in morbid obese patients. Results: Fifty-three (88.3%) patients were female and seven (11.7%) were male. Eight of the 60 patients (13.3%) had previously undergone cholecystectomy. Six patients (11.5%) underwent cholecystectomy in addition to LRYGB due to preoperatively detected gallstones by ultrasonography. The remaining 46 patients were followed up for a mean duration of 28.57 months (5-56 months). In 10 (21.7%) of these patients, gallstones were detected and five patients with symptomatic gallstones underwent cholecystectomy. Patients who did and did not develop gallstones after LRYGB did not show a significant difference regarding age, gender and the new body mass index (BMI). Three patients were started on ursodeoxycholic acid and the treatment was continued for six months. Gallstones were not detected in these patients. Conclusion:In light of these data, since only a very small portion of patients develops symptomatic gallstones after LRYGB, we recommend cholecystectomy in patients with symptomatic gallstones or the use of ursodeoxycholic acid rather than a prophylactic approach. Prospective randomized controlled studies in larger series are required to support these results.

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“…The prevalence of cholelithiasis, symptomatic or not, is directly correlated to the body mass index (BMI) [6,[8][9][10]. Additionally, it has been clearly shown that periods of rapid weight loss further enhance the risk of cholesterol cholelithiasis [11][12][13]. In order to reduce the risk of gallstone formation and its complications, policies of routine prophylactic cholecystectomy [6], use of intra-operative ultrasound for gallstone detection and concomitant cholecystectomy [12,14,15], postoperative use of ursodeoxycholic acid [15,16], regular ultrasound surveillance for asymptomatic gallstone [12,[14][15][16], and their combinations have been suggested.…”

Section: Introductionmentioning

confidence: 99%

Predictors of Gallstone Formation in Morbidly Obese Patients after Bariatric Surgery: A Retrospective Observational Study

Abo-Ryia¹,

Abdallah²,

El-Khadrawy³

et al. 2014

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Background: Obesity alone and rapid weight loss induced by bariatric surgery are recognized risk factors for the development of cholelithiasis. This study aimed to identify the predictive factors for gallstone formation after bariatric surgery. Patient and methods: The files of all morbidly obese patients underwent bariatric surgery in our unit during the period from March 2003 till October 2010 were reviewed and analyzed. All patients underwent routine preoperative ultrasonography and selective concomitant cholecystectomy was done in all patients with ultrasonographic-confirmed cholelithiasis. After excluding cases with prior and concomitant cholecystectomies, patients were divided into two groups; those who developed gallstones and those who did not and the two groups were compared. Results: Of the 143 reviewed files 135 were eligible to be included in the study. The incidence of cholelithiasis before surgery was 25.9% (35 cases). 19 cases (19%) of the 100 cases free at surgery developed gallstone at a mean of 13.2 months. Comparing the two groups, no significant difference was revealed regarding gender, age, preoperative BMI or type of the operation. But the percent of excess weight loss was significantly higher in the group that formed gallstones. Conclusion: Gender, age, preoperative BMI and type of the operation were not predictive of gallstones formation after bariatric surgery. The percent of excess weight loss was the only predictive postoperative factor.

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Impact of Rapid Weight Reduction on Risk of Cholelithiasis after Bariatric Surgery

Abstract: This study confirms the high correlation between morbid obesity, rapid weight loss and gallbladder disease. Predictive risk factors for gallstone formation were not found.

Cited by 177 publications

References 12 publications

Is concomitant cholecystectomy with laparoscopic sleeve gastrectomy safe?

Is concomitant cholecystectomy with laparoscopic sleeve gastrectomy safe?

The evaluation of gallstone formation in patients undergoing Roux-en -Y gastric bypass due to morbid obesity

Predictors of Gallstone Formation in Morbidly Obese Patients after Bariatric Surgery: A Retrospective Observational Study

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