Risk of biliary complications in bariatric surgery

Abstract

Gallstones are commonly observed after rapid weight loss, particularly after bariatric surgery. Preventive measures of gallstone formation and potential related complications are still debated. This study aimed to propose a standardized strategy according to the results of the literature. Thus, preventive measures should be determined according to patient status (evaluated clinically and by routine ultrasound) and the type of bariatric surgery. Cholecystectomy should be performed in patients with symptomatic gallstones irrespective of the planned operation, or for asymptomatic gallstones during a gastric by-pass. In other settings, ursodesoxycholic acid should be given postoperatively for 6 months.

Safety issues with glucagon‐like peptide‐1 receptor agonists (pancreatitis, pancreatic cancer and cholelithiasis): Data from randomized controlled trials

“…Notably, results of the present meta‐analysis on incident cholelithiasis are concordant with those of a large‐scale retrospective observational study . In addition, a relevant increase in the risk of cholelithiasis is observed also with some forms of bariatric surgery, which also increase endogenous GLP‐1 secretion; in that case, however, a massive and rapid weight loss could have contributed to the increase of risk. The possibility of a direct effect of GLP1 receptor stimulation on the development of cholelithiasis or cholecystitis deserves to be explored through specifically designed studies.…”

Clinical evaluation of double-channel gastroscope for endoscopic retrograde cholangiopancreatography in patients with Billroth II gastrectomy

“…3) The reduction of gastric acid secretion induced by gastrectomy may lead to a decrease in the bacteria in the gastrointestinal tract, and the retrograde motion of bacteria in the duodenum to the bile duct may induce bile duct infection, thus increasing the incidence rate of the primary choledocholithiasis. 4) The short or long afferent loop may induce retention of a large amount of food, which leads to bile duct infection and choledocholithiasis [ 5 ].…”

Hepaticojejunostomy for the management of sump syndrome arising from choledochoduodenostomy in a patient who underwent bariatric Roux-en-Y gastric bypass: A case report

“…The incidence of obesity is increasing worldwide, especially in developing countries, and bariatric surgery has emerged as an often utilized solution to the problem [4] . Rapid weight loss, as is expected with bariatric surgery, is a known risk factor for gallstone formation [3] and associated complications, which can require intervention [4] , [5] .…”