Prevalence of symptomatic and asymptomatic gallstones in laparoscopic sleeve gastrectomy

Nowadays obesity is one of the major health problems worldwide, leading many obese patients to undergo surgical intervention. Laparoscopic sleeve gastrectomy (LSG) is a common approach for surgical management of morbid obesity. Gallbladder stones are a common side effect of sudden weight loss after bariatric surgery. The aim of this study was to investigate the relationship between weight loss and gallstones and the need for prophylactic cholecystectomy.

This cross-sectional study was conducted on all patients who had undergone gastric sleeve surgery in Babol University of Medical Sciences hospitals during 2013- 2017. Demographic data such as gender, age, weight, and BMI were collected with informed consent via a questionnaire. Patients were followed up over an 18-month period by ultrasound and by a visit from the surgeon. The incidence of gallstones and gallbladder sludge and the need for cholecystectomy were studied.

In this study, 114 patients including 94 females and 20 males with a mean age of 37.4±8.29 years and mean weight of 142.23±10.29 kg underwent LSG. The incidence of asymptomatic and symptomatic gallstones was 23% (26/114) and 7% (8/114), respectively. An apparent relationship was observed between weight loss and the incidence of gallstones during the follow-up periods, except for the first month. Moreover, ursodeoxycholic acid administration reduced significantly the incidence of gallbladder sludge and stones (p<0.001).

The results suggest that the formation of gallstones during the period of weight loss is related to the amount or rate of weight loss in the postoperative period.