Complicated gallstones after laparoscopic sleeve gastrectomy

Area of Science:

• Bariatric Surgery
• Gastroenterology
• Gallbladder Disease

Background:

• The natural history of gallstone formation post-laparoscopic sleeve gastrectomy (LSG) is not well understood.
• Incidence of symptomatic gallstones and optimal timing for cholecystectomy after LSG require clarification.

Purpose of the Study:

• To investigate the incidence and characteristics of gallstone formation after LSG.
• To determine the optimal timing for cholecystectomy in patients undergoing LSG.

Main Methods:

• Retrospective review of a prospectively collected database of 150 patients who underwent LSG.
• Analysis of preoperative and postoperative gallbladder disease incidence and complications.

Main Results:

• Preoperative gallbladder disease was present in 23.2% of patients.
• Postoperatively, 5.8% of patients developed symptomatic gallstones, with a cumulative incidence of 4.7%.
• Gallbladder disease-free survival was 92.2% at 2 years; cholecystectomies occurred between 9 and 23 months post-LSG.

Conclusions:

• A significant number of bariatric patients develop symptomatic gallstones and complications after LSG.
• Early cholecystectomy is warranted due to the high complication rate and short time to onset.
• Routine concomitant cholecystectomy may be considered due to high complication rates and technical challenges of later procedures.