Objective
The use of laparoscopic sleeve gastrectomy (LSG) has risen steadily as a treatment for adolescents with obesity. This study determined whether obstructive biliary complications after rapid, LSG‐related weight loss occur similarly in adolescents compared with adults.
Methods
Between 2010 and 2019, 309 patients underwent LSG. Demographics and clinical factors, including pre‐ and perioperative BMI and weight changes, were included.
Results
Overall, 21 patients (7%) had post‐LSG biliary disease (BD), of whom 13 presented with acute pancreatitis (AP) and 8 with biliary colic. No differences existed between those with BD (n = 21) and the remaining cohort (n = 288). Patients with BD were 16.3 (SD 2.4) years of age at LSG, with a preoperative BMI of 49.3 (SD 6.7) kg/m2. Preoperative excess BMI loss was 7.1% (SD 11.3%). An ultrasound revealed gallstones (71%) and sludge or crystals (12%). Eighteen patients underwent cholecystectomy between 4 weeks and 29 months after LSG.
Conclusions
Pediatric patients present with BD at a similar rate after LSG compared with adults. The majority of adolescents, however, manifest with AP. Thus, pancreatitis should be high on the differential diagnosis list when evaluating post‐LSG abdominal symptoms. Additional studies are warranted to elucidate the pathophysiology of post‐LSG AP for prevention in the future because its etiology may or may not be solely related to BD.