Prevalence of Cholelithiasis and Associated Factors of Gallstone Formation after Laparoscopic Sleeve Gastrectomy in the Gastroenterology and Hepatology Teaching Hospital-Baghdad
DOI:
https://doi.org/10.32007/jfacmedbaghdad.6642381Keywords:
Bariatric Surgery, BMI., Gallstone, Obesity, Laparoscopic Sleeve GastrectomyAbstract
Background: Bariatric surgery (BS) is the most effective method for long-term weight loss. Rapid weight reduction after BS may contribute to the formation of gallstones.
Objectives: To assess the rate, and to identify the associated factors, of gallstone formation after laparoscopic sleeve gastrectomy.
Methods: This was a cross-sectional study among 128 patients with morbid obesity, who were treated with laparoscopic sleeve gastrectomy and followed up at two weeks, one month, six months, and one year after surgery between October 2018 and July 2020, at the Gastroenterology and Hepatology Teaching Hospital in Baghdad and the Dowaly Private Hospital. Data was collected using a structured questionnaire.
Results: The mean age of patients was 36.5±5.21 (17–54) for females and 41.6 ±3.04 (24–58) for males. Gallstone formation happened in 49 cases (38.3%). Of all males, four (36.4%) developed gallstones after (LSG), compared to 45 (38.5%) females. Sixty (46.9%) patients had a Body Mass Index (BMI) ≥40 kg/m2, of whom 29 (48.3%) developed gallstones after LSG (p = 0.031). The p-values for weight loss regarding timing and degree of loss show a significant relationship with gallstone formation after LSG (p < 0.05). Comorbid conditions were not significantly associated with the incidence of gallstone formation after LSG (p > 0.05).
Conclusions: More than a third of the cases developed gallstones after Laparoscopic Sleeve Gastrectomy. This was associated with Gross obesity prior to surgery (BMI ≥ 40 kg/m²), losing ≥25% of the original weight, and rapid weight loss during the first six months after LSG.
Received: May. 2024
Revised: Aug. 2024
Accepted: Dec. 2024
Published: Dec.,2024
Downloads
References
1. Garvey WT, Mechanick JI. Proposal for a scientifically correct and medically actionable disease classification system (ICD) for obesity. Obesity (Silver Spring) 2020; 28(3):484–492. https://doi.org/10.1002/oby.22727.
2. Kloock S, Ziegler CG, Ulrich Dischinger U. Obesity and its comorbidities, current treatment options and future perspectives: Challenging bariatric surgery? Pharmacology & Therapeutics 251 (2023) 108549, 1-17. https://doi.org/10.1016/j.pharmthera.2023.108549
3. Holst JJ, Madsbad S, Bojsen-Møller KN, Svane MS, Jørgensen NB, Carsten D et al. (2018) Mechanisms in bariatric surgery: gut hormones, diabetes resolution, and weight loss. Surg Obes Relat Dis; 2018,14:708–714. https://doi.org/10.1016/j.soard.2018.03.003.
4. Dimitriadis GK, Randeva MS, Miras AD. Potential Hormone Mechanisms of Bariatric Surgery. Curr Obes Rep. 2017 Sep;6(3):253-265. https://doi.org/10.1007/s13679-017-0276-5.
5. Dai Y, Luo B, Li W. Incidence and risk factors for cholelithiasis after bariatric surgery: a systematic review and meta-analysis. Lipids Health Dis 22, 5 (2023). https://doi.org/10.1186/s12944-023-01774-7
6. Abdulnaser MM, Hussien AA, Abdulrahman Mohammed. Prevalence of Anxiety and Depression Symptoms among Post Bariatric Surgery Patients in Baghdad-Iraq. JFacMedBagdad [Internet]. 2024 Jan. 1 [cited 2024 Jan. 26];65(4). Available from: https://iqjmc.uobaghdad.edu.iq/index.php/19JFacMedBaghdad36/article/view/2129
7. Boerlage TC, Haal S, Maurits de Brauw L, Acherman YI, Bruin S, Moes DE, et al. Ursodeoxycholic acid for the prevention of symptomatic gallstone disease after bariatric surgery: study protocol for a randomized controlled trial (UPGRADE trial). BMC Gastroenterol. 2017;17:164. http://link.springer.com/article/10.1186/s12876-017-0674-x
8. Talha A, Abdelbaki T, Farouk A, Hasouna E, Azzam E, Shehata G. Cholelithiasis after bariatric surgery, incidence, and prophylaxis: randomized controlled trial. Surg Endosc. 2020 Dec;34(12):5331-5337. https://doi.org/10.1007/s00464-019-07323-7.
9. Shubayr N, Elbashir M, Alashban Y, Ali S, Jafaari M, Hendi A, et al. Incidence of Gallbladder Stone Formation After Bariatric Surgery Using Ultrasound Imaging in the Southern Region of Saudi Arabia. Cureus. 2022 Jun 15;14(6):e25948. https://doi.org/10.7759/cureus.25948.
10. Altalhi RA, Alsaqqa RM, Alasmari RM, Aljuaid A, Althobaiti L, Mahfouz MEM. The Incidence of Cholelithiasis After Bariatric Surgery in Saudi Arabia and Its Associated Risk Factors. Cureus. 2023 Jun 17;15(6):e40549. https://doi.org/10.7759/cureus.40549.
11. Coupaye M, Castel B, Sami O, Tuyeras G, Msika S, Ledoux S. Comparison of the incidence of cholelithiasis after sleeve gastrectomy and Roux-en-Y gastric bypass in obese patients: a prospective study. Surg Obes Relat Dis. 2015 Jul-Aug;11(4):779-84. https://doi.org/10.1016/j.soard.2014.10.015.
12. Manatsathit W, Leelasinjaroen P, Al-Hamid H, Szpunar S, Hawasli A. The Incidence of cholelithiasis after sleeve gastrectomy and its association with weight loss: a two-centre retrospective cohort study. Int J Surg. 2016; 30:13–8. https://doi.org/10.1016/j.ijsu.2016.03.060.
13. Adams LB, Chang C, Pope J, Kim Y, Liu P, Yates A. Randomized, Prospective Comparison of Ursodeoxycholic Acid for the Prevention of Gallstones after Sleeve Gastrectomy. Obes Surg. 2016 May;26(5):990-4.
https://doi.org/10.1007/s11695-015-1858-5.
14. Wan Q, Zhao R, Chen Y, Wang Y, Wu Y, Wu X. Comparison of the incidence of cholelithiasis after sleeve gastrectomy and Roux-en-Y gastric bypass: a meta-analysis. Surg Obes Relat Dis. 2021 Jun;17(6):1198-1205. https://doi.org/10.1016/j.soard.2021.02.003.
15. Yildirim K, Karabicak I, Gursel M F, Karabicak C, Malazgirt Z. The outcome of concomitant cholecystectomy with bariatric surgery: a retrospective cohort study. Annals of Medicine & Surgery, 2023;85(4):718-721. https://doi.org/10.1097/MS9.0000000000000339.
16. Veldhuisen SL, Gorter TM, van Woerden G, de Boer RA, Rienstra M, Hazebroek EJ, et al. Bariatric surgery and cardiovascular disease: A systematic review and meta-analysis. European Heart Journal, 2022;43,1955–1969. https://doi.org/10.1093/eurheartj/ehac071.
17. Alsaif FA, Alabdullatif FS, Aldegaither MK, Alnaeem KA, Alzamil AF, Alabdulkarim NH, et al. Incidence of symptomatic cholelithiasis after laparoscopic sleeve gastrectomy and its association with rapid weight loss. Saudi J Gastroenterol. 2020 Mar-Apr;26(2):94-98. https://doi.org/10.4103/sjg.SJG_472_19.
18. Mishra T, Lakshmi KK, Peddi KK. Prevalence of Cholelithiasis and Choledocholithiasis in Morbidly Obese South Indian Patients and the Further Development of Biliary Calculus Disease After Sleeve Gastrectomy, Gastric Bypass and Mini Gastric Bypass. Obes Surg. 2016 Oct;26(10):2411-7. https://doi.org/10.1007/s11695-016-2113-4.
19. Cirillo DJ, Wallace RB, Rodabough RJ, Greenland P, LaCroix AZ, Limacher MC, et al. Effect of estrogen therapy on gallbladder disease. JAMA. 2005 Jan 19;293(3):330-9. https://doi.org/10.1001/jama.293.3.330.
20. Galyani Moghaddam T, Fakheri H, Abdi R, Khosh Bavar Rostami F, Bari Z. The incidence and outcome of pregnancy-related biliary sludge/stones and potential risk factors. Arch Iran Med. 2013 Jan;16(1):12-6. https://pubmed.ncbi.nlm.nih.gov/23273228/
21.Racine A, Bijon A, Fournier A, Mesrine S, Clavel-Chapelon F, Carbonnel F, et al. Menopausal hormone therapy and risk of cholecystectomy: a prospective study based on the French E3N cohort. CMAJ. 2013 Apr 16;185(7):555-61. https://doi.org/10.1503/cmaj.121490.
22. El Shaer AE, Ammar MS, Fawzy AM, Hagag MG. Assessment of gallstone formation after bariatric surgery. Int Surg J. 2019 Jan;6(1):37-41. https://doi.org/10.18203/2349-2902.isj20185120.
23. Keilani ZM, El Djouzi S, Kuwada TS, Gersin K, Simms C, Stefanidis D. What are the Incidence and timing of cholecystectomy after bariatric surgery? Poster presentation, the program no. P503, SAGES 2024 Annual Meeting; San Diego, CA. Accessed at: 14 April 2024, available at: https://www.sages.org/meetings/annual-meeting/abstracts-archive/what-are-the-incidence-and-timing-of-cholecystectomy-after-bariatric-surgery/
24. Grover BT, Kothari S. Biliary issues in the bariatric population. Surg Clin North Am. 2014 Apr;94(2):413-25. https://doi.org/10.1016/j.suc.2014.01.003.
25. Al Maliki A, Lami F, Al Aboudi S. Prevalence and Determinants of Depression among Diabetic Patients,Babel Province, Iraq, 2013-2014. JFacMedBagdad [Internet]. 2015 Jan. 4 [cited 2024 Apr. 13];56(4):411-6. Available from: https://iqjmc.uobaghdad.edu.iq/index.php/19JFacMedBaghdad36/article/view/558
26. Al-Kadhimi FA, Al-Hemiary NJ, Hassan A. Depressive Symptoms & Associated Stressors among Medical Students. JFacMedBagdad [Internet]. 2017 Oct. 1 [cited 2024 Apr. 13];59(3):226-30. Available from: https://iqjmc.uobaghdad.edu.iq/index.php/19JFacMedBaghdad36/article/view/92.
Downloads
Published
Issue
Section
License
Copyright (c) 2024 Abdulrahman M. Mohammed, Abdulnaser M. Mohammed, Tuka Y. Hassan
This work is licensed under a Creative Commons Attribution 4.0 International License.
Creative Commons Attribution 4.0 International license..
