Gallbladder Management in Obesity Surgery

Mason, Edward E.; Renquist, Kathleen E

doi:10.1381/096089202762552395

Cited by 81 publications

(44 citation statements)

References 6 publications

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“…Two hundred of 796 (25.1%) patients had evidence of previous gallbladder diseases as evidenced by either history of cholecystectomy or cholelithiasis detected on routine preoperative transabdominal ultrasound. This finding was similar to those observed in other studies [17][18][19]. Additionally, 65 of 796 (8.2%) of patients were found to have asymptomatic gallstones or sludge on routine preoperative ultrasound and were recommended to undergo concomitant cholecystectomy as is routine at our institute.…”

Section: Discussionsupporting

confidence: 91%

“…It has been postulated that, during rapid weight loss, cholesterol was mobilized from tissues stores and was excreted in bile, resulting in so-called lithogenic bile due to increased bile cholesterol saturation index. Others found that increased gallbladder secretion of mucin and calcium and increased presence of prostaglandins and arachidonic acid in bile had significant attribution to gallstone formation [10][11][12][13]. The risks of developing gallstones between the different weight reduction procedures, such as a complex restrictive-malabsorptive procedure or simple restrictive procedure, may be different.…”

Section: Discussionmentioning

confidence: 99%

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Predictors of gallstone formation after bariatric surgery: a multivariate analysis of risk factors comparing gastric bypass, gastric banding, and sleeve gastrectomy

et al. 2008

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Section: Discussionsupporting

confidence: 91%

Section: Discussionmentioning

confidence: 99%

Predictors of gallstone formation after bariatric surgery: a multivariate analysis of risk factors comparing gastric bypass, gastric banding, and sleeve gastrectomy

et al. 2008

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“…It has been postulated that, during rapid weight loss, cholesterol was mobilized from tissues stores and was excreted in bile, resulting in socalled lithogenic bile due to increased bile cholesterol saturation index. Others found that increased gallbladder secretion of mucin and calcium and increased presence of prostaglandins and arachidonic acid in bile had significant attribution to gallstone formation [5,9,28,29]. Of the 19 cases developed gallstones in our study, 8 (42%) were symptomatic.…”

Section: Open Access Ssmentioning

confidence: 46%

Predictors of Gallstone Formation in Morbidly Obese Patients after Bariatric Surgery: A Retrospective Observational Study

Abo-Ryia¹,

Abdallah²,

El-Khadrawy³

et al. 2014

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Background: Obesity alone and rapid weight loss induced by bariatric surgery are recognized risk factors for the development of cholelithiasis. This study aimed to identify the predictive factors for gallstone formation after bariatric surgery. Patient and methods: The files of all morbidly obese patients underwent bariatric surgery in our unit during the period from March 2003 till October 2010 were reviewed and analyzed. All patients underwent routine preoperative ultrasonography and selective concomitant cholecystectomy was done in all patients with ultrasonographic-confirmed cholelithiasis. After excluding cases with prior and concomitant cholecystectomies, patients were divided into two groups; those who developed gallstones and those who did not and the two groups were compared. Results: Of the 143 reviewed files 135 were eligible to be included in the study. The incidence of cholelithiasis before surgery was 25.9% (35 cases). 19 cases (19%) of the 100 cases free at surgery developed gallstone at a mean of 13.2 months. Comparing the two groups, no significant difference was revealed regarding gender, age, preoperative BMI or type of the operation. But the percent of excess weight loss was significantly higher in the group that formed gallstones. Conclusion: Gender, age, preoperative BMI and type of the operation were not predictive of gallstones formation after bariatric surgery. The percent of excess weight loss was the only predictive postoperative factor.

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“…In addition to increased frequency of various other diseases, obese patients have increased frequency of gallstones compared to the normal population (21-33%). The increase in the secretion of cholesterol by the liver and the reduced contractility of the gallbladder due to the increased cholesterol concentration without a proportional increase in phospholipids and bile salts play an important role in the formation of gallstones (12)(13)(14).…”

Section: Discussionmentioning

confidence: 99%

The evaluation of gallstone formation in patients undergoing Roux-en -Y gastric bypass due to morbid obesity

Karadeniz¹,

Görgün²,

Kara³

2014

UCD

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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. 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.

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Gallbladder Management in Obesity Surgery

Cited by 81 publications

References 6 publications

Predictors of gallstone formation after bariatric surgery: a multivariate analysis of risk factors comparing gastric bypass, gastric banding, and sleeve gastrectomy

Predictors of gallstone formation after bariatric surgery: a multivariate analysis of risk factors comparing gastric bypass, gastric banding, and sleeve gastrectomy

Predictors of Gallstone Formation in Morbidly Obese Patients after Bariatric Surgery: A Retrospective Observational Study

The evaluation of gallstone formation in patients undergoing Roux-en -Y gastric bypass due to morbid obesity

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