Prevalence of symptomatic and asymptomatic gallstones in laparoscopic sleeve gastrectomy

Abstract Background: Nowadays obesity is one of the major health problems worldwide, leading many obese patients to undergo surgical intervention. Laparoscopic sleeve gastrectomy (LSG) is a common approach for surgical management of morbid obesity. Gallbladder stones are a common side effect of sudden weight loss after bariatric surgery. The aim of this study was to investigate the relationship between weight loss and gallstones and the need for prophylactic cholecystectomy. Methods: This cross-sectional study was conducted on all patients who had undergone gastric sleeve surgery in Babol University of Medical Sciences hospitals during ۲۰۱۳- ۲۰۱۷. Demographic data such as gender, age, weight, and BMI were collected with informed consent via a questionnaire. Patients were followed up over an ۱۸-month period by ultrasound and by a visit from the surgeon. The incidence of gallstones and gallbladder sludge and the need for cholecystectomy were studied. Results: In this study, ۱۱۴ patients including ۹۴ females and ۲۰ males with a mean age of ۳۷.۴±۸.۲۹ years and mean weight of ۱۴۲.۲۳±۱۰.۲۹ kg underwent LSG. The incidence of asymptomatic and symptomatic gallstones was ۲۳% (۲۶/۱۱۴) and ۷% (۸/۱۱۴), respectively. An apparent relationship was observed between weight loss and the incidence of gallstones during the follow-up periods, except for the first month. Moreover, ursodeoxycholic acid administration reduced significantly the incidence of gallbladder sludge and stones (p<۰.۰۰۱). Conclusion: The results suggest that the formation of gallstones during the period of weight loss is related to the amount or rate of weight loss in the postoperative period.

Keywords:

Sleeve gastrectomy , Obesity , Gallstone , Gallbladder sludge