Can we Predict Gallstone Formation after Bariatric Surgery

Author:Mohammad H. Abo-Ryia

Obesity is a worldwide health problem. Surgery has been demonstrated to be the most effective method to achieve long-term sustained weight loss in the morbidly obese with resolution of most co-morbidities. However it is agreed that gallstone formation is increased after weight reduction surgery followed by rapid weight loss. So identifying risk factors for gallstone development after weight reduction surgery is important to avoid its complications.

In Mohammad Abo-Ryia’ research review from Department of Surgery at Tanta University, Egypt, published in Surgical Science 2014 vol.5 by Scientific Research Publishing. His team conducted their study to identify the predictors of gallstone formation after weight reduction surgery. They compared the patients who formed gallstones and those who did not as regard: gender, age, preoperative BMI, type of operation and   percent of excess weight loss. The results indicate that gender, age, preoperative BMI and type of the operation were not predictive of gallstones formation. Only the percent of excess weight loss postoperatively was the predictor of gallstone formation.

And as this will not be useful in preventing its formation, it will be wise to adopt either the policy of prophylactic use of ursodeoxycholic acid in patients who will be compliant and can afford its cost or the policy of the regular postoperative ultrasound surveillance and subsequent cholecystectomy once gallstones were identified to avoid presentation with complications specially after RYGBP where there is no access to the biliary passages.

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