Weight gain after cholecystectomy.

Abstract

but a low titre to the porcine agent.3 Before operation a test dose was given to ascertain the therapeutic response and to detect side effects.4 In this case shivering, nausea, and back pain occurred but were rapidly relieved by oral chlorpheniramine. During the early postoperative period we gave 100 mg hydrocortisone and 10 mg chlorpheniramine intravenously before each infusion, later using chlorpheniramine alone. The platelet count remained unchanged. Altogether 270 000 units of porcine factor VIII were given without any appreciable rise in the titre of antibodies to this agent or an increased tendency towards side effects.Though a prolonged conservative approach to management of a pseudotumour may be successful, it was clearly failing in this patient. The new porcine factor enabled us to overcome the problem of achieving and maintaining haemostasis during and after major surgery.We thank Professor R B Duthie and Dr C Rizza for permission to report on their patient and for their helpful advice. Weight gain after cholecystectomyCholecystectomy is currently the most common major general surgical operation, with about 45 000 operations being performed each year in the United Kingdom.' A retrospective study of patients undergoing biliary surgery in this hospital suggested that many patients gain weight after cholecystectomy (paper in preparation). We therefore undertook a prospective study to examine weight change after cholecystectomy. Methods and resultsOne hundred and three patients undergoing elective operations for benign biliary disease were entered into the study. None had acute cholecystitis immediately before their operation. The patients comprised 31 men and 72 women with mean ages of 57 (range 32-75) and 53 (16-81), respectively.One patient died postoperatively (mortality 10o'), after the leakage of a choledochoduodenostomy. The patients were weighed in their underclothes and a light dressing gown on the day before operation and six weeks, three months, and six months after discharge from hospital.Six months after operation 75 of the patients had gained weight, 21 had lost weight, and seven remained at their preoperative weight. The table shows the mean weights over the six month study period. An increase in weight was apparent at three months, although this had no significance until six months. The patients were subdivided to see whether the weight changes were related to sex, preoperative body weight, or age. Twenty seven (870o) of the men gained weight compared with 49 (680 ) of the women, a difference that was not significant (X2 test). The men lost a little weight in the first six weeks after operation but then showed an increase at three months and a significant gain at six months (paired Student's t test). The women gained weight steadily, but the increase was not significant until six months postoperatively. In both sexes preoperative obesity, which we arbitrarily defined as over 70 kg in women and 80 kg in men, did not appear to influence weight gain. When patients aged below 65 were compared ...

Cholecystectomy increases the risk of metabolic syndrome in the Korean population: a longitudinal cohort study

“…The current study supports the data suggesting a link between cholecystectomy and MetS. This finding is in line with those of previous studies that reported a significant weight gain or elevation of glucose levels among cholecystectomized patients ( 3 , 27 ). Other studies showed that subjects with gall bladder disease or those who had undergone cholecystectomy had higher plasma TG levels, as well as higher levels of total cholesterol, but lower levels of HDL-C, than patients who had not undergone cholecystectomy ( 3 , 28 ).…”

Cholecystectomy as a risk factor of metabolic syndrome: from epidemiologic clues to biochemical mechanisms

“…An earlier study 28 reported a significant weight gain among cholecystectomized patients, with men and women gaining a mean of 4.6% and 3.3%, respectively, of their preoperative body weight at 6months after surgery. Other studies 27,29 that compared subjects with and without gallstones reported that, when compared with subjects without gallstones, the body mass index (BMI) and waist circumference of subjects with gallstones tended to be higher, and these differences were even more pronounced in cholecystectomized subjects ( Table 2).…”

Gallstone disease risk in relation to body mass index and waist-to-hip ratio in Japanese men

“…It is possible that the observed positive association between obesity and postcholecystectomy may have been due to weight gain after cholecystectomy. 25,26 Caution is thus needed in interpreting the ®ndings regarding postcholecystectomy. Although rapid weight reduction is known to enhance gallstone formation, 27,28 much of the risk associated with weight loss or dieting has been ascribed to the underlying obesity or excess weight before dieting.…”