Increased Incidence of Symptomatic Cholelithiasis After Bariatric Roux-En-Y Gastric Bypass and Previous Bariatric Surgery: a Single Center Experience
| Autor: | Hasan Kais, Assaf Rotmensh, Hadas Razin, Sharon Moscovici, Haim Shirin, Ahmad Elnasasra, Lotem Harel, Midhat Abu Sneineh |
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| Rok vydání: | 2020 |
| Předmět: |
Adult
Male Reoperation medicine.medical_specialty Endocrinology Diabetes and Metabolism medicine.medical_treatment Gallbladder disease Gastric Bypass Bariatric Surgery 030209 endocrinology & metabolism Comorbidity Gallstones Biliary colic Asymptomatic 03 medical and health sciences 0302 clinical medicine Postoperative Complications Cholelithiasis Risk Factors medicine Humans Cholecystectomy Risk factor Aged Retrospective Studies Nutrition and Dietetics business.industry Incidence (epidemiology) Incidence Middle Aged medicine.disease Roux-en-Y anastomosis Surgery Obesity Morbid 030211 gastroenterology & hepatology Female Laparoscopy medicine.symptom business Follow-Up Studies |
| Zdroj: | Obesity surgery. 30(3) |
| ISSN: | 1708-0428 |
| Popis: | Bariatric surgery predisposes patients to cholelithiasis and therefore the need of a subsequent cholecystectomy; however, the incidence of cholecystectomy after bariatric surgery is debated. Medical records of 601patients hospitalized for bariatric surgery between January 2010 and July 2018 were reviewed. Our aim was to evaluate the incidence of cholecystectomy following different types of common bariatric procedures. All patients who developed cholelithiasis and a subsequent cholecystectomy were included. Cholelithiasis was diagnosed by clinical criteria and characteristic ultrasound findings. We retrospectively evaluated 580 patients with an average follow-up of 12 months (range 6–24 months). Twenty-one patients were excluded because of missing data. Mean age was 48 ± 19 years (78% females). Twenty-nine patients (5%) underwent laparoscopic cholecystectomy (LC) before the bariatric surgery, and 58 patients (10%) performed concomitant LC with the bariatric procedure due to symptomatic gallstone disease (including stones, sludge, and polyps). There were 203 laparoscopic sleeve gastrectomy (SG) (35%), 175 laparoscopic gastric band (LAGB) (30%), 55 Roux-en-Y gastric bypass (RYGB) (9.5%), and 147 (25%) mini gastric bypass (MGB) procedures during the study period. At the follow-up period, 36 patients (6.2%) developed symptomatic cholelithiasis, while the most common clinical presentation was biliary colic. There was a significant difference between the type of the bariatric procedure and the incidence of symptomatic cholelithiasis after the operation. The incidence of symptomatic gallstone formation in patients who underwent RYGB was 14.5%. This was significantly higher comparing to 4.4% following SG, 4.1% following LAGB, and 7.5% following MGB (p = 0.04). We did not find any predictive risk factors including smoking; BMI at surgery; change in BMI; comorbidities such as diabetes, hyperlipidemia, hypertension, and COPD for gallstone formation; or a subsequent cholecystectomy. Interestingly we found that previous bariatric surgery was a risk factor for gallstone formation and cholecystectomy, 13/82 patients (15.8%) compared to 23/492 patients (4.6%) among those without previous bariatric operation (p |
| Databáze: | OpenAIRE |
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