Abstract
After bariatric surgery, patients are at increased risk for gallstone formation and subsequent common bile duct stones. Patients who have undergone sleeve gastrectomy or placement of a restrictive gastric band may be managed in the standard fashion with endoscopic retrograde cholangiopancreatography. Those who have undergone a Roux-en-Y gastric bypass or a duodenal switch require specialized techniques to treat their common bile duct stones. These complex techniques require specialized equipment and training and typically are performed at large referral centers. The choice of technique depends on the available expertise and urgency of biliary intervention.
Keywords
This is a preview of subscription content, log in via an institution.
Buying options
Tax calculation will be finalised at checkout
Purchases are for personal use only
Learn about institutional subscriptionsReferences
Tsirline VB, Keilani ZM, El Djouzi S, Phillips RC, Kuwada TS, Gersin K, Simms C, Stefanidis D. How frequently and when do patients undergo cholecystectomy after bariatric surgery? Surg Obes Relat Dis. 2014;10(2):313–21. doi:10.1016/j.soard.2013.10.011.
Li VK, Pulido N, Fajnwaks P, Szomstein S, Rosenthal R, Martinez-Duartez P. Predictors of gallstone formation after bariatric surgery: a multivariate analysis of risk factors comparing gastric bypass, gastric banding, and sleeve gastrectomy. Surg Endosc. 2009;23(7):1640–4. doi:10.1007/s00464-008-0204-6.
Everhart JE, Khare M, Hill M, Maurer KR. Prevalence and ethnic differences in gallbladder disease in the United States. Gastroenterology. 1999;117(3):632–9.
Hutson DG, Russell E, Schiff E, Levi JJ, Jeffers L, Zeppa R. Balloon dilatation of biliary strictures through a choledochojejuno-cutaneous fistula. Ann Surg. 1984;199(6):637–47.
Amitha Vikrama KS, Keshava SN, Surendrababu NR, Moses V, Joseph P, Vyas F, Sitaram VJ. Jejunal access loop cholangiogram and intervention using image guided access. Med Imaging Radiat Oncol. 2010;54(1):5–8. doi:10.1111/j.1754-9485.2010.02130.x.
Kim J, Schirmer B. Safety and efficacy of simultaneous cholecystectomy at Roux-en-Y gastric bypass. Surg Obes Relat Dis. 2009;5:48–53.
Mason EE, Renquist KE. Gallbladder management in obesity surgery. Obes Surg. 2002;12(2):222–9.
Swartz DE, Feliz EK. Elective cholecystectomy after Roux-en-Y gastric bypass: why should asymptomatic gallstones be treated differently in morbidly obese patients? Surg Obes Relat Dis. 2005;1:555–60.
Patel KR, White SC, Tejirian T, et al. Gallbladder management during laparoscopic Roux-en-Y gastric bypass surgery: routine preoperative screening for gallstones and postoperative prophylactic medical treatment are not necessary. Am Surg. 2006;72:857–61.
Sugarman HJ, Brewer WH, Shiffman ML, et al. A multicenter, placebo-controlled, randomized, double-blind, prospective trial of prophylactic ursodiol for the prevention of gallstone formation following gastric bypass induced rapid weight loss. Am J Surg. 1995;169:91–6.
Miller K, Hell E, Lang B, et al. Gallstone formation prophylaxis after gastric restrictive procedures for weight loss. Ann Surg. 2003;238:697–702.
Grover BT, Kothari SN. Biliary issues in the bariatric population. Surg Clin North Am. 2014;94(2):413–25. doi:10.1016/j.suc.2014.01.003.
Baron TH, Vickers SM. Surgical gastrostomy placement as access for diagnostic and therapeutic ERCP. Gastrointest Endosc. 1998;22:640–1.
Peters M, Papsavas PK, Caushak PF, et al. Laparoscopic transgastric endoscopic retrograde cholangiopancreatography for benign common bile duct stricture after Roux-en-Y gastric bypass. Surg Endosc. 2002;16:1106.
Facchiano E, Quartararo G, Pavoni V, et al. Laparoscopic-assisted transgastric endoscopic retrograde cholangiopancreatography (ERCP) after Roux-en-Y gastric bypass: technical features. Obes Surg. 2014;25:373.
Richardson JF, Lee JG, Smith BR, Nguyen B, Pham KP, Nguyen NT. Laparoscopic transgastric endoscopy after Roux-en-Y gastric bypass: case series and review of the literature. Am Surg. 2012;78(10):1182–6.
Grimes KL, Maciel VH, Mata W, et al. Complications of laparoscopic transgastric ERCP in patients with Roux-en-Y gastric bypass. Surg Endosc. 2015;29:1753.
Koc B, Karahan S, Adas G, et al. Comparison of laparoscopic common bile duct exploration and endoscopic retrograde cholangiopancreatography plus laparoscopic cholecystectomy for choledocholithiasis: a prospective randomized study. Am J Surg. 2013;206:457–63.
Buxbaum J. Modern management of common bile duct stones. Gastrointest Endosc Clin N Am. 2013;23(2):251–75. doi:10.1016/j.giec.2012.12.003.
Dasari BV, Tan CJ, Gurusamy KS, Martin DJ, Kirk G, McKie L, Diamond T, Taylor MA. Surgical versus endoscopic treatment of bile duct stones. Cochrane Database Syst Rev 2013; 9: CD003327. doi: 10.1002/14651858.CD003327.pub3
Ducoin C, Moon RC, Teixeira AF, et al. Laparoscopic choledochoduodenostomy as an alternate treatment for common bile duct stones after Roux-en-Y gastric bypass. Surg Obes Relat Dis. 2014;10:647–53.
Ozcan N, Kahriman G, Mavili E. Percutaneous transhepatic removal of bile duct stones: results in 261 patients. Cardiovasc Intervent Radiol. 2012;35:621–7.
Hazey JW, McCreary M, Guy G, Melvin WS. Efficacy of percutaneous treatment of biliary tract calculi using the holmium: YAG laser. Surg Endosc. 2007;21(7):1180–3.
Fonetin DB, Gibson RN, Collier NA. Two decades of percutaneous transjejunal biliary intervention for benign biliary disease: a review of the intervention nature and complication. Insights Imaging. 2011;5:557–65.
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2016 Springer International Publishing Switzerland
About this chapter
Cite this chapter
Jones, T.S., Narula, V.K. (2016). Special Considerations: Management of Common Bile Duct Stones in the Bariatric Patient. In: Hazey, J., Conwell, D., Guy, G. (eds) Multidisciplinary Management of Common Bile Duct Stones. Springer, Cham. https://doi.org/10.1007/978-3-319-22765-8_15
Download citation
DOI: https://doi.org/10.1007/978-3-319-22765-8_15
Publisher Name: Springer, Cham
Print ISBN: 978-3-319-22764-1
Online ISBN: 978-3-319-22765-8
eBook Packages: MedicineMedicine (R0)