Incidence of cholelithiasis after laparoscopic sleeve gastrectomy Incidence of cholelithiasis after laparoscopic sleeve gastrectomy
Main Article Content
Keywords
Bariatric procedures, bariatric surgery, cholecystectomy, labcholy, incidence, basrah
Abstract
Background:
Laparoscopic sleeve gastrectomy is a well-known method for weight reduction. Post-operative weight loss is a major risk factor for gallstone formation.
Objective:
To determine whether prophylactic concomitant laparoscopic cholecystectomy should be performed on all patients at the time of laparoscopic sleeve gastrostomy or not.
Patients and Methods:
A retrospective and prospective study on 540 patients with morbid obesity who underwent laparoscopic sleeve gastrectomy; their BMI range was between 38 and 53, their age range was 18 to 63 years, and 335 of them were females. The exclusion criteria were patients with a history of cholecystectomy, gallstone patients or gallbladder polyps more than 1 cm in preoperative abdominal ultrasound, and those who failed to follow-up. All patients were followed up with every 6–12 months, including those who had cholecystectomy by other surgeons.
Results:
During the study period, from the total 540 patients who had laparoscopic sleeve gastrectomy, 167 patients (30.92%) had cholecystectomy, out of which 20 patients (3.7%) had achieved 45% weight reduction during the first six months; while in another 6 months, 147 patients (27.22%) had cholecystectomy, achieving additional 30% weight reduction.
Conclusions: The incidence of gallstones after laparoscopic sleeve gastrostomy is about 30.92%, indicating that 69.08% will not have gallstones in the postoperative follow-up period, so it would be unwise to do prophylactic concomitant cholecystectomy for all patients.
Keywords: Bariatric procedures, cholecystectomy, incidence
References
2. Asnat Razil, Nasser Sakran, et al. Concomitant cholecystectomy during laparoscopic sleeve gastrectomy. Surg Endosc.2014;10.
3. Vicky kM, Pedro MS, Hei YS, et al. Symptomatic gallstones after sleeve gastrectomy. SurgEndosc(2009);23:2488–92.
4. Wuttiporn M, Pornchai L, Hussein AH, et al. The incidence of cholelithiasis after gastrectomy and its association with loss: A two-center retrospective cohort study. International Journal of Surgery.2016;30:13–18.
5. Kehagias, A Zygomalas, et al. Sleeve gastrectomy; have we finally found the holy grail of bariatric surgery?. European Review for Medical and Pharmacological Sciences.2016;20:4930–42.
6. KaraManaKOssn, vagenas K, KalFarenTzOs F, alexandrides TK. Weight loss, appetite suppression, and changes in fasting and postprandial ghrelin and peptide-YY levels after Roux-en-Y gastric bypass and sleeve gastrectomy: a prospective, double blind study. Ann Surg 2008;247:401–7.
7. EleniSioka, Dimitris Zacharoulis, EleniZachari, et al. Complicated Gallstones after laparoscopic Sleeve Gastrectomy. Hindawi Publishing Corporation, Journal of Obesity.2014.Id468203.
8. Hanaa N.D, Hebah M.E., Hussein A.A, et al. Safety of concomitant cholecystectomy at the time of laparoscopic sleeve gastrectomy: analysis of the American College of surgeons National Surgical Quality Improvement Program database. Surgery for Obesity and related Disease.2017;13:934–42.
9. Tucker ON, Fajnmaks P, Szomstein S, et al. Is concomitant cholecystectomy necessary in obese patients undergoing laparoscopic gastric bypass surgery?. SurgEndosc. 2008;22(11):2450–4.
10. Escalona A, Boza C, Munoz R, et al. Routine preoperative ultrasonography and selective cholecystectomy in laparoscopic Roux-en-Y gastric bypass.why not? Obes Surg. 2008;18(1):47–51.
11. Nougou A, Suter M. Almost routine prophylactic cholecystectomy during laparoscopic gastric bypass is safe. Obes Surg. 2008;18(5):535–9.
12. Ulf Gustafsson, LisbetBenthin, et al. change in Gallbladder Bile Composition and Crystal Detection Time in Morbidly Obese Subjects After Bariatric Surgery. Hepatology. 2005;41:1322–8.
13. HalilCoskun, Mustafa Hashahceci, Suleyman Bozkurt, et al. Is concomitant cholecystectomy with laparoscopic sleeve gastrectomy safe? Turk J Gastroenterol. 2014;25:624–7.
14. Dr. Osama T. Abu Salem, Dr. Ibrahim Al Gwairy, et al. Gallbladder disease associated with laparoscopic sleeve gastrectomy in jorgan. Indian Journal of Medical Research and Pharmaceutical Sciences. 2017;4(7):21–25.
15. Iglezias Brandao de Oliveira C, Adami Chaim E, da Silva BB. Impact of rapid weight reduction on risk of cholelithiasis after bariatric surgery. ObesSurg 2003;13:625–8.
16. Sakcak I, Avsar FM, Cosgun E, Yildiz BD. Management of concurrent cholelithiasis in gastric banding for morbid obesity. Eur J GastroenterolHepatol 2011;23:766–9.
17. Ammori BJ, Vezakis A, Davides D, Martin IG, Larvin M, McMahon MJ (2001) laparoscopic cholecystectomy in morbidly obese patients. SurgEndosc 15:1136–9.
18. Bassam Ahmed Al-Mutlaq, Haitham Ahmad Alnais, et al. Gallstones Formation Prophylaxis after Bariatric Surgery:Experience in Saudi Arabia. International Journal of Medical Research and Health Science. 2017;6(12):27–34.
19. Andrzej Lehmann, MaciejBobowicz, et al. Comparison of percentage excess weight loss after laparoscopic sleeve gastrectomy and laparoscopic adjustable gastric banding. VideosurgeryMiniinv. 2014;9 (3):351–9.
20. Mechanick JI, Youdim A, Jones DB, et al. Clinical practice guide- lines for the perioperative nutritional, metabolic, and nonsurgical support of the bariatric surgery patient—2013 update: cosponsored by the American Association of Clinical Endocrinologists, the Obesity Society, and American Society for Metabolic & Bariatric Surgery. SurgObesRelat Dis. 2013;9(2):159–91.
21. Pineda O, Maydón HG, Amado M, et al. A prospective study of the conservative management of asymptomatic preoperative and postoperative gallbladder disease in bariatric surgery. Obes Surg. 2017;27(1):148–53.
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