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Biliary Disease and Bariatric Surgery

  • Mariano Palermo
  • Pablo Acquafresca
  • Flávio Coelho Ferreira
  • Cinthia Barbosa de Andrade
  • Josemberg Campos
Chapter

Abstract

It is known that the rapid weight loss is a predisposing factor to develop biliary lithiasis. Compared with the general population, the obese have high levels of serum cholesterol, determining a higher incidence of lithiasis, which is further increased in the patient population undergoing a bariatric procedure. Furthermore, after bariatric surgery, a decrease in the gallbladder motility due to nerve damage, a deficit in phospholipids and contraction-stimulating proteins, and an increase of mucin secretion toward the gallbladder occur, leading to an acceleration of the nucleation process.

Regarding prophylactic surgery (cholecystectomy), the majority of surgeons concur that a watchful waiting should be taken and only perform the bariatric procedure, because the number of patients that will develop symptomatic cholelithiasis is low (around 6–8% of them) and this leads to an elevated number of patients exposed to an unnecessary procedure with potential complications. Laparoscopic cholecystectomy in bariatric patients may be challenging due to suboptimal port placement and difficult body habitus. Furthermore, it is accompanied by potential risks such as lengthening of operative time, increased morbidity, and prolonged hospitalization.

Keywords

Bariatric surgery Biliary disease Gallbladder CDB 

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Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  • Mariano Palermo
    • 1
  • Pablo Acquafresca
    • 2
  • Flávio Coelho Ferreira
    • 3
  • Cinthia Barbosa de Andrade
    • 3
  • Josemberg Campos
    • 3
  1. 1.Department of Bariatric SurgeryCentro Cien– DiagnomedBuenos AiresArgentina
  2. 2.Department of SurgeryDAICIM FoundationBuenos AiresArgentina
  3. 3.Department of SurgeryFederal University of Pernambuco (UFPE)RecifeBrazil

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