The Evaluation of Gallstone Formation in Patients Undergoing Roux-en-Y Gastric Bypass Due to Morbid Obesity

Overview

Journal Ulus Cerrahi Derg

Specialty General Surgery

Date 2015 May 2

PMID 25931899

Citations 7

Authors

Metin Karadeniz

Mehmet Gorgun

Cemal Kara

Affiliations

Soon will be listed here.

Abstract

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.

Material And Methods: Files of 60 patients who underwent LRYGB between October 2006 and March 2011 were retrospectively reviewed. Patients were evaluated for formation of gallstones.

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.

Citing Articles

Surgical management of gallstone ileus after one anastomosis gastric bypass: A case report.

El Feghali E, Akel R, Chamaa B, Kazan D, Chakhtoura G World J Gastrointest Surg. 2023; 15(9):2083-2088.

PMID: 37901746 PMC: 10600774. DOI: 10.4240/wjgs.v15.i9.2083.

Risk and Prophylactic Management of Gallstone Disease in Bariatric Surgery: a Systematic Review and A Bayesian meta-analysis.

Amorim-Cruz F, Santos-Sousa H, Ribeiro M, Nogueiro J, Pereira A, Resende F J Gastrointest Surg. 2023; 27(2):433-448.

PMID: 36627465 PMC: 9974690. DOI: 10.1007/s11605-022-05567-8.

Incidence of Symptomatic Cholelithiasis Following Laparoscopic Roux-en-Y Gastric Bypass Is Comparable to Laparoscopic Sleeve Gastrectomy: A Cohort Study.

Golzarand M, Toolabi K, Parsaei R, Eskandari Delfan S Dig Dis Sci. 2021; 67(8):4188-4194.

PMID: 34783969 DOI: 10.1007/s10620-021-07306-6.

Increased Incidence of Symptomatic Cholelithiasis After Bariatric Roux-En-Y Gastric Bypass and Previous Bariatric Surgery: a Single Center Experience.

Sneineh M, Harel L, Elnasasra A, Razin H, Rotmensh A, Moscovici S Obes Surg. 2020; 30(3):846-850.

PMID: 31901127 DOI: 10.1007/s11695-019-04366-6.

Bariatric Surgery Did Not Increase the Risk of Gallstone Disease in Obese Patients: a Comprehensive Cohort Study.

Chen J, Tsai M, Chen C, Lee H, Cheng C, Chiu Y Obes Surg. 2018; 29(2):464-473.

PMID: 30417273 DOI: 10.1007/s11695-018-3532-1.

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