Jian-Han Chen1,2,3, Ming-Shian Tsai1,2,3, Chung-Yen Chen1,2,3, Hui-Ming Lee3,4, Chi-Fu Cheng5,6, Yu-Ting Chiu5,6, Wen-Yao Yin7,8,9, Cheng-Hung Lee10,11. 1. Bariatric and Metabolic Surgery Center, E-da hospital, Kaohsiung, Taiwan. 2. Department of General Surgery, E-da hospital, Kaohsiung, Taiwan. 3. School of Medicine, I-Shou University, Kaohsiung, Taiwan. 4. Department of General Surgery, E-Da Cancer Hospital, Kaohsiung, Taiwan. 5. Department of General Surgery, Buddhist Dalin Tzu Chi Hospital, No.2, Minsheng Rd., Dalin Township, Chiayi County, 622, Taiwan. 6. School of Medicine, Tzu Chi University, Hualien, Taiwan. 7. Department of General Surgery, Buddhist Dalin Tzu Chi Hospital, No.2, Minsheng Rd., Dalin Township, Chiayi County, 622, Taiwan. wenyao4748@gmail.com. 8. School of Medicine, Tzu Chi University, Hualien, Taiwan. wenyao4748@gmail.com. 9. Department of Surgery, College of Medicine, Tzu Chi University, Hualien, Taiwan. wenyao4748@gmail.com. 10. Department of General Surgery, Buddhist Dalin Tzu Chi Hospital, No.2, Minsheng Rd., Dalin Township, Chiayi County, 622, Taiwan. kawa199190@gmail.com. 11. School of Medicine, Tzu Chi University, Hualien, Taiwan. kawa199190@gmail.com.
Abstract
PURPOSE: The aim of this study was to evaluate the influence of bariatric surgery on gallstone disease in obese patients. MATERIALS AND METHODS: This large cohort retrospective study was conducted based on the Taiwan National Health Insurance Research Database. All patients 18-55 years of age with a diagnosis code for obesity (ICD-9-CM codes 278.00-278.02 or 278.1) between 2003 and 2010 were included. Patients with a history of gallstone disease and hepatic malignancies were excluded. The patients were divided into non-surgical and bariatric surgery groups. Obesity surgery was defined by ICD-9-OP codes. We also enrolled healthy civilians as the general population. The primary end point was defined as re-hospitalization with a diagnosis of gallstone disease after the index hospitalization. All patients were followed until the end of 2013, a biliary complication occurred, or death. RESULTS: Two thousand three hundred seventeen patients in the bariatric surgery group, 2331 patients in the non-surgical group, and 8162 patients in the general population were included. Compared to the non-surgery group (2.79%), bariatric surgery (2.89%) did not elevate the risk of subsequent biliary events (HR = 1.075, p = 0.679). Compared to the general population (1.15%), bariatric surgery group had a significantly higher risk (HR = 4.996, p < 0.001). In the bariatric surgery group, female gender (HR = 1.774, p = 0.032) and a restrictive procedure (HR = 1.624, p = 0.048) were risk factors for gallstone disease. CONCLUSION: The risk for gallstone disease did not increase after bariatric surgery, although the risk was still higher than the general population. The benefit of concomitant cholecystectomy during bariatric surgery should be carefully evaluated.
PURPOSE: The aim of this study was to evaluate the influence of bariatric surgery on gallstone disease in obesepatients. MATERIALS AND METHODS: This large cohort retrospective study was conducted based on the Taiwan National Health Insurance Research Database. All patients 18-55 years of age with a diagnosis code for obesity (ICD-9-CM codes 278.00-278.02 or 278.1) between 2003 and 2010 were included. Patients with a history of gallstone disease and hepatic malignancies were excluded. The patients were divided into non-surgical and bariatric surgery groups. Obesity surgery was defined by ICD-9-OP codes. We also enrolled healthy civilians as the general population. The primary end point was defined as re-hospitalization with a diagnosis of gallstone disease after the index hospitalization. All patients were followed until the end of 2013, a biliary complication occurred, or death. RESULTS: Two thousand three hundred seventeen patients in the bariatric surgery group, 2331 patients in the non-surgical group, and 8162 patients in the general population were included. Compared to the non-surgery group (2.79%), bariatric surgery (2.89%) did not elevate the risk of subsequent biliary events (HR = 1.075, p = 0.679). Compared to the general population (1.15%), bariatric surgery group had a significantly higher risk (HR = 4.996, p < 0.001). In the bariatric surgery group, female gender (HR = 1.774, p = 0.032) and a restrictive procedure (HR = 1.624, p = 0.048) were risk factors for gallstone disease. CONCLUSION: The risk for gallstone disease did not increase after bariatric surgery, although the risk was still higher than the general population. The benefit of concomitant cholecystectomy during bariatric surgery should be carefully evaluated.
Authors: Dana D Portenier; John P Grant; Hilary S Blackwood; Aurora Pryor; Ross L McMahon; Eric DeMaria Journal: Surg Obes Relat Dis Date: 2007-04-18 Impact factor: 4.734
Authors: Anna C Weiss; Tazo Inui; Ralitza Parina; Alisa M Coker; Garth Jacobsen; Santiago Horgan; Mark Talamini; David C Chang; Bryan Sandler Journal: Surg Endosc Date: 2014-12-17 Impact factor: 4.584