Muriel Coupaye1, Benjamin Castel2, Ouidad Sami3, Géraud Tuyeras2, Simon Msika2, Séverine Ledoux3. 1. Service des Explorations Fonctionnelles, Centre de référence de prise en charge de l'obésité, Hôpital Louis Mourier (AP-HP), Université Paris Diderot, Sorbonne Paris Cité, France. Electronic address: muriel.coupaye@lmr.aphp.fr. 2. Service de Chirurgie, Centre de référence de prise en charge de l'obésité, Hôpital Louis Mourier (AP-HP), Université Paris Diderot, Sorbonne Paris Cité, France. 3. Service des Explorations Fonctionnelles, Centre de référence de prise en charge de l'obésité, Hôpital Louis Mourier (AP-HP), Université Paris Diderot, Sorbonne Paris Cité, France.
Abstract
BACKGROUND: Although the risk of cholelithiasis (CL) increases in patients after Roux-en-Y gastric bypass (RYGB), no prospective study has yet assessed the incidence of CL after sleeve gastrectomy (SG). OBJECTIVES: To compare, prospectively, the incidence and predictive factors for CL after both procedures. METHODS: A postoperative abdominal ultrasound follow-up was proposed to all patients with an intact gallbladder and who underwent RYGB or SG in Hôpital Louis Mourier from 2008 onward. RESULTS: At least one ultrasound was performed on one hundred and sixty patients between 6 and 12 months postsurgery, 43 after SG and 117 after RYGB. Age, gender, initial body-mass index, co-morbidities were similar in both groups. Weight loss (WL) at 6 months was significantly lower after SG than after RYGB (26.9 ± 9.2 and 31.3 ± 7.5 kg, respectively = .001). The incidences of CL after SG and RYGB were similar (28% versus 34% respectively, P = .57). Most cases of CL occurred in the first year post surgery. During the follow-up, 12% and 13% of patients who underwent SG and RYGB, respectively, became symptomatic. WL of>30 kg at 6 months was a risk factor for CL after bariatric surgery, but we did not find any preoperative predictive factor for gallstone formation. CONCLUSIONS: Despite lower WL after SG, the incidence of CL after SG and RYGB was similar at 2 years. Our results suggest that rapid WL is the main element leading to gallstone formation after both procedures.
BACKGROUND: Although the risk of cholelithiasis (CL) increases in patients after Roux-en-Y gastric bypass (RYGB), no prospective study has yet assessed the incidence of CL after sleeve gastrectomy (SG). OBJECTIVES: To compare, prospectively, the incidence and predictive factors for CL after both procedures. METHODS: A postoperative abdominal ultrasound follow-up was proposed to all patients with an intact gallbladder and who underwent RYGB or SG in Hôpital Louis Mourier from 2008 onward. RESULTS: At least one ultrasound was performed on one hundred and sixty patients between 6 and 12 months postsurgery, 43 after SG and 117 after RYGB. Age, gender, initial body-mass index, co-morbidities were similar in both groups. Weight loss (WL) at 6 months was significantly lower after SG than after RYGB (26.9 ± 9.2 and 31.3 ± 7.5 kg, respectively = .001). The incidences of CL after SG and RYGB were similar (28% versus 34% respectively, P = .57). Most cases of CL occurred in the first year post surgery. During the follow-up, 12% and 13% of patients who underwent SG and RYGB, respectively, became symptomatic. WL of>30 kg at 6 months was a risk factor for CL after bariatric surgery, but we did not find any preoperative predictive factor for gallstone formation. CONCLUSIONS: Despite lower WL after SG, the incidence of CL after SG and RYGB was similar at 2 years. Our results suggest that rapid WL is the main element leading to gallstone formation after both procedures.
Authors: Sylke Haal; Djoeke Rondagh; Barbara A Hutten; Yair I Z Acherman; Arnold W J M van de Laar; Roeland Huijgen; Victor E A Gerdes; Rogier P Voermans Journal: Obes Surg Date: 2020-02 Impact factor: 4.129
Authors: Shivanshu Misra; B Deepa Nandhini; S Christinajoice; S Saravana Kumar; S Prabhakaran; C Palanivelu; P Praveen Raj Journal: Obes Surg Date: 2020-07-29 Impact factor: 4.129