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Incidence of Gallstone Formation and Cholecystectomy 10 Years After Bariatric Surgery

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Abstract

Purpose

Rapid weight loss is a risk factor for gallstone formation, and postoperative treatment options for gallstone formation are still part of scientific discussion. No prospective studies monitored the incidence for gallstone formation and subsequent cholecystectomy after bariatric surgery longer than 5 years. The aim of the study was to determine the incidence of gallstone formation and cholecystectomy in bariatric patients over 10 years.

Materials and methods

One hundred nine patients were observed over 10 years after laparoscopic gastric banding or gastric bypass/gastric sleeve. The incidence of gallstone formation and cholecystectomy was correlated to longitudinal changes in anthropometric parameters.

Results

In total, 91 female and 18 male patients were examined. Nineteen patients had postoperative gallstone formation, and 12 female patients required cholecystectomy. The number needed to harm for gallstone formation was 7.1 and 2.3 cases in the banding group and gastric bypass/gastric sleeve group, respectively. The number needed to harm for cholecystectomy was 11.6 and 2.5 cases in the banding group and the gastric bypass/gastric sleeve group, respectively. Weight loss was higher in patients requiring subsequent cholecystectomy. Mean follow-up to cholecystectomy was 21.5 months with the latest operation after 51 months.

Conclusion

Female gender and rapid weight loss were major risk factors for postoperative cholelithiasis. Ultrasound examinations within 2 to 5 years are recommended in every patient, independent of bariatric procedure. Pharmacologic treatment should be considered in high risk patients within 2 to 5 years to prevent postoperative cholelithiasis. This helps to optimize patient care and lowers postoperative morbidity.

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Acknowledgments

The expert technical assistance of Dr. Karin Salzmann is gratefully acknowledged. This study was supported by the Austrian Science Fund (FWF) KLI 348 and by the Austrian Science Fund ZFP 266730.

The corresponding author, Prof. Dr. Christoph Ebenbichler, had full access to all data in the study and had the final responsibility for the decision to submit for publication.

Authors Contributions

Andreas Melmer was involved in manuscript preparation, data analysis, patients’ recruitment, and clinical examination. Wolfgang Sturm performed the ultrasound examinations; Bernhard Kuhnert was involved in manuscript preparation and data analysis; Julia Engl-Prosch was involved in manuscript preparation, patients’ recruitment and clinical examination; Claudia Ress was involved in patients’ recruitment and clinical examination; Alexander Tschoner was involved in patients recruitment and clinical examination; Markus Laimer was involved in manuscript preparation; Elisabeth Laimer performed the bariatric surgery; Matthias Biebl performed the bariatric surgery; Johann Pratschke performed the bariatric surgery; Herbert Tilg was involved in manuscript preparation; and Christoph Ebenbichler is the principal investigator of the study and was involved in manuscript preparation, patients’ recruitment, and clinical examination.

Conflict of Interest

The authors declare that they have no conflict of interest.

Informed Consent

Informed consent was obtained from all individual participants included in the study.

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Authors and Affiliations

  1. Department of Internal Medicine I, Medical University of Innsbruck, Anichstrasse 35, 6020, Innsbruck, Austria

    Andreas Melmer, Wolfgang Sturm, Bernhard Kuhnert, Julia Engl-Prosch, Claudia Ress, Alexander Tschoner, Markus Laimer, Herbert Tilg & Christoph Ebenbichler

  2. Department of General, Thoracic and Transplant Surgery, Medical University of Innsbruck, Innsbruck, Austria

    Elisabeth Laimer

  3. Department for General, Visceral and Transplantation Surgery, University Hospital Charite, Berlin, Germany

    Matthias Biebl & Johann Pratschke

Authors
  1. Andreas Melmer
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  2. Wolfgang Sturm
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  3. Bernhard Kuhnert
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  4. Julia Engl-Prosch
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  7. Markus Laimer
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  8. Elisabeth Laimer
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  9. Matthias Biebl
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  12. Christoph Ebenbichler
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Corresponding author

Correspondence to Christoph Ebenbichler.

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Melmer, A., Sturm, W., Kuhnert, B. et al. Incidence of Gallstone Formation and Cholecystectomy 10 Years After Bariatric Surgery. OBES SURG 25, 1171–1176 (2015). https://doi.org/10.1007/s11695-014-1529-y

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  • DOI: https://doi.org/10.1007/s11695-014-1529-y

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