Incidence of symptomatic gallstones after bariatric surgery: the impact of expectant management

• Type: Article in International Scientific Journal
• Date: 2023

Authors

Nogueiro, J (Author) Other; Santos Sousa, H (Author) FMUP; Ribeiro, M (Author) Other; Cruz, F (Author) Other; Pereira, A (Author) Other; Resende, F (Author) Other; André Pinho (Author) FMUP; John Preto (Author) Other; Sousa Pinto, B (Author) FMUP; Lima da Costa, E (Author) Other; Carneiro, S (Author) Other

Journal

The Journal is awaiting validation by the Administrative Services.

Title: LANGENBECKS ARCHIVES OF SURGERY

Vol. 408

ISSN: 1435-2443

Publisher: Springer

Indexing

ISI Web of Knowledge - 2 Citations

Scopus - 1 Citation

Other information

Authenticus ID: P-00Y-BC6

DOI: 10.1007/s00423-023-02904-6

Abstract (EN): BackgroundBariatric surgery is the most effective treatment for sustained weight reduction and obesity-related comorbidities. The development of gallstones as a result of rapid weight loss is a well-known consequence of bariatric procedures. It remains unclear, if there is an increased risk of these gallstones becoming symptomatic.MethodsA retrospective analysis of 505 consecutive patients submitted to either Roux-en-Y Gastric Bypass or Sleeve Gastrectomy between January and December 2019 was performed. The aim of our study was to determine the incidence of symptomatic cholelithiasis in asymptomatic patients with their gallbladder in situ after bariatric surgery and to identify potential risk factors for its development.ResultsOf the 505 patients included, 79 (15.6%) underwent either previous cholecystectomy.(n = 67, 84.8%) or concomitant cholecystectomy during bariatric surgery (n = 12, 15.2%). Among the remaining 426 (84.4%) patients, only 8 (1.9%) became symptomatic during the 12-month follow-up period. When compared with patients who remained asymptomatic, they had a higher median preoperative BMI (47.0 vs. 42.8, p = 0.046) and prevalence of cholelithiasis on preoperative ultrasound (62.5% vs. 10.7%, p = 0.001). Multivariate analysis revealed preoperative BMI and cholelithiasis on preoperative ultrasound as independent risk factors for symptomatic biliary disease (OR 1.187, 95%CI 1.025-1.376, p = 0.022 and OR 10.720, 95%CI 1.613-71.246, p = 0.014, respectively).ConclusionConsidering a low incidence of symptomatic gallstones after bariatric surgery, concomitant cholecystectomy should only be performed in symptomatic patients undergoing bariatric surgery. Preoperative factors, such as a higher BMI and positive ultrasound for cholelithiasis, may be related to the development of symptomatic gallstones.

Language: English

Type (Professor's evaluation): Scientific

No. of pages: 8