Predictive factors of biliary complications after bariatric surgery

Chang, Julietta; Corcelles, Ricard; Boules, Mena; Jamal, Mohammad H.; Schauer, Philip R.; Kroh, Matthew

doi:10.1016/j.soard.2015.11.004

Cited by 39 publications

(30 citation statements)

References 23 publications

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“…Identification of risk factors in bariatric patients is important because it may provide opportunities for preventive therapy in high-risk patients. Until now, studies showed that weight loss, Caucasian race, female gender, advanced age, and insulin resistance are risk factors for (symptomatic) gallstones after bariatric surgery [2][3][4][5][13][14][15][16][17]. Nevertheless, results of these studies were not consistent, studies were small in size, and majority of these studies focused on ultrasound-confirmed gallstones instead of symptomatic gallstones.…”

Section: Introductionmentioning

confidence: 99%

Risk Factors for Cholecystectomy After Laparoscopic Roux-En-Y Gastric Bypass

et al. 2019

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Background Patients who have undergone bariatric surgery are at risk for subsequent cholecystectomy. We aimed to identify risk factors for cholecystectomy after laparoscopic Roux-en-Y gastric bypass (LRYGB). Methods We conducted a retrospective case-control study of patients who underwent LRYGB between 2013 and 2015. Cases underwent cholecystectomy because of biliary symptoms after LRYGB. For each case, two controls were selected without subsequent cholecystectomy. Logistic regression analyses were used to identify risk factors. Results Between 2013 and 2015, 1780 primary LRYGBs were performed. We identified 233 (13.1%) cases who had undergone cholecystectomy after a median (IQR) of 12 (8-17) months, and 466 controls. Female gender (OR (95% CI) 1.83 (1.06-3.17)), Caucasian ethnicity (OR (95% CI) 1.82 (1.10-3.02)), higher percent total weight loss (%TWL) at 12 months (OR (95% CI) 1.06 (1.04-1.09)), and preoperative pain syndrome (OR (95% CI) 2.72 (1.43-5.18)) were significantly associated with an increased risk for cholecystectomy. Older age (OR (95% CI) 0.98 (0.96-0.99)) and preoperative statin use were associated with a reduced risk (OR (95% CI) 0.56 (0.31-1.00)). A dose-effect relationship was found between the intensity of preoperative statin and risk for cholecystectomy. Conclusions In our study, higher %TWL and preoperative pain syndrome were associated with an increased risk for cholecystectomy besides the traditional risk factors female gender and Caucasian ethnicity. These factors can be used to identify high-risk patients, who might benefit from preventive measures. Whether statins can protect bariatric patients from developing gallstones should be investigated prospectively.

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Section: Introductionmentioning

confidence: 99%

Risk Factors for Cholecystectomy After Laparoscopic Roux-En-Y Gastric Bypass

et al. 2019

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“…Out of those 138 patients only 10 (0.27%) developed acute pancreatitis with mean time from surgery being 1.8 ± 1.4 years. Female gender, age > 50, cholelithiasis at the time of bariatric procedure, and Roux-en-Y gastric bypass were identified as predictive factors of pancreatic-biliary complications [8], with no mention of LSG as a definitive risk factor. On the other hand, portomesenteric vein thrombosis as an independent entity was found only in 5 patients out of 1236 (0.4%) following LSG in another recently published retrospective study [9] with smoking identified as a predominant risk factor.…”

Section: Discussionmentioning

confidence: 99%

Acute Pancreatitis with Splenic Infarction as Early Postoperative Complication following Laparoscopic Sleeve Gastrectomy

Kalabin

Mani

Mishra

et al. 2017

Case Reports in Surgery

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Obesity is becoming a global health burden along with its comorbidities. It imposes tremendous financial burden and health costs worldwide. Surgery has emerged as the definitive treatment option for morbidly obese patients with comorbidities. Laparoscopic sleeve gastrectomy is performed now more than ever making it imperative for physicians and surgeons to recognize both the common and the uncommon risks and complications associated with it. In this report we describe a rare early life-threatening postoperative complication following laparoscopic sleeve gastrectomy. From our extensive review of literature, there is no existing report of acute pancreatitis with splenic infarction postsleeve gastrectomy to this date.

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“…Although safe, laparoscopic cholecystectomy performed concurrently with laparoscopic bariatric surgery has significant potential complications that can lengthen operative time, increase morbidity, and prolong hospitalization [10]. Prophylactic cholecystectomy during gastric bypass was historically recommended in the era of open surgery [11].…”

Section: Routine Prophylactic Cholecystectomymentioning

confidence: 99%