Åsa Anveden1, Markku Peltonen2, Ingmar Näslund3, Jarl Torgerson4, Lena M S Carlsson4. 1. Department of Surgery at Halland Hospital, Halmstad, Sweden; Department of Molecular and Clinical Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden. Electronic address: asa.anveden@regionhalland.se. 2. Department of Molecular and Clinical Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; Department of Chronic Disease Prevention, National Institute of Health and Welfare, Helsinki, Finland. 3. Department of Surgery, Faculty of Medicine and Health, Örebro University Hospital, Örebro, Sweden. 4. Department of Molecular and Clinical Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
Abstract
BACKGROUND: Gallstone disease is a known short-term complication of bariatric surgery; little is known of the long-term incidence. OBJECTIVES: The aim of this study was to investigate the association between bariatric surgery and long-term incidence of gallstone disease. SETTINGS: A total of 25 surgery departments and 480 primary healthcare centers in Sweden. METHODS: The Swedish Obese Subjects study is a prospective, controlled study comparing the effects of bariatric surgery with usual care with a follow-up of 20 years, including 4047 individuals. The current report includes all participants without previous or concomitant cholecystectomy (n = 3597). Operative techniques used in the surgery group (n = 1755) were gastric bypass (n = 236), vertical banded gastroplasty (n = 1202), and gastric banding (n = 317). The control group (n = 1842) received customary treatment for obesity. Gallstone disease was a predefined secondary endpoint in the Swedish Obese Subjects study and the primary endpoint of this report. Data were obtained by cross-checking our study database with the Swedish National Patient Register of diagnosis and procedures. RESULTS: In the surgery and control groups, respectively, there were 307 and 252 first-time events of symptomatic gallstone disease and 230 and 170 cholecystectomies (log-rank P < .001, both outcomes). Bariatric surgery was associated with an increased risk of symptomatic gallstone disease, with a more pronounced risk during the first years of follow-up (P = .002) and an increased risk for cholecystectomy but with no time-varying effect (P = .213). CONCLUSIONS: Bariatric surgery increases the risk for symptomatic gallstone disease and cholecystectomy, especially during the first years following treatment.
BACKGROUND:Gallstone disease is a known short-term complication of bariatric surgery; little is known of the long-term incidence. OBJECTIVES: The aim of this study was to investigate the association between bariatric surgery and long-term incidence of gallstone disease. SETTINGS: A total of 25 surgery departments and 480 primary healthcare centers in Sweden. METHODS: The Swedish Obese Subjects study is a prospective, controlled study comparing the effects of bariatric surgery with usual care with a follow-up of 20 years, including 4047 individuals. The current report includes all participants without previous or concomitant cholecystectomy (n = 3597). Operative techniques used in the surgery group (n = 1755) were gastric bypass (n = 236), vertical banded gastroplasty (n = 1202), and gastric banding (n = 317). The control group (n = 1842) received customary treatment for obesity. Gallstone disease was a predefined secondary endpoint in the Swedish Obese Subjects study and the primary endpoint of this report. Data were obtained by cross-checking our study database with the Swedish National Patient Register of diagnosis and procedures. RESULTS: In the surgery and control groups, respectively, there were 307 and 252 first-time events of symptomatic gallstone disease and 230 and 170 cholecystectomies (log-rank P < .001, both outcomes). Bariatric surgery was associated with an increased risk of symptomatic gallstone disease, with a more pronounced risk during the first years of follow-up (P = .002) and an increased risk for cholecystectomy but with no time-varying effect (P = .213). CONCLUSIONS: Bariatric surgery increases the risk for symptomatic gallstone disease and cholecystectomy, especially during the first years following treatment.
Authors: Kajsa Sjöholm; Lena M S Carlsson; Per-Arne Svensson; Johanna C Andersson-Assarsson; Felipe Kristensson; Peter Jacobson; Markku Peltonen; Magdalena Taube Journal: Diabetes Care Date: 2022-02-01 Impact factor: 19.112