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A Prospective Study of the Conservative Management of Asymptomatic Preoperative and Postoperative Gallbladder Disease in Bariatric Surgery

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Abstract

Introduction

Bariatric surgery is the most effective therapy for weight loss in patients with morbid obesity. One of the most common long-term complications includes cholelithiasis. There is not a clear consensus in how to treat an asymptomatic gallbladder disease before and after bariatric surgery.

Methods

Prospective study with every patient submitted to bariatric surgery from 2012 to 2014. The gallbladder status was assessed with an ultrasound before and after surgery (12 months), and a conservative management was conducted for patients with asymptomatic disease (preoperative and de novo); the need for delayed cholecystectomy was reported. Secondarily, an analysis of weight loss (%EWL) and gallbladder status was performed.

Results

Two-hundred and two bariatric surgeries were performed. The global incidence of preoperative gallbladder disease was 34.3 %, with 14.2 % presenting sludge, 20.1 % asymptomatic gallstones, and 2.3 % symptomatic gallstones. The final analysis was based on 146 patients; female sex comprised 81.1 % of cases with a mean age of 38.5 years. After 12 months, de novo gallbladder disease was observed in 21.2 %. The overall rate of cholecystectomy because of symptomatic disease after 12 months was 3.4 % (2 % developed acute cholecystitis). There were no differences in %EWL between patients with de novo gallbladder disease and those without.

Conclusion

Conservative management of asymptomatic gallbladder disease in candidates to bariatric surgery is safe and can be offered in every case, based on the low percentage of patients requiring further cholecystectomy after 12 months. Also, a conservative management can be offered to patients developing de novo sludge/cholelithiasis without related symptoms.

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Authors and Affiliations

  1. The Obesity Clinic at “Hospital General Tláhuac”, Avenida La Turba #655, Col. Villa Centroamericana y del Caribe, Del. Tláhuac, CP 13278, Mexico City, Mexico

    Omar Pineda, Hernán G. Maydón, Mónica Amado, Elisa M. Sepúlveda, Lizbeth Guilbert, Omar Espinosa & Carlos Zerrweck

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  1. Omar Pineda
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  2. Hernán G. Maydón
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  3. Mónica Amado
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  4. Elisa M. Sepúlveda
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  5. Lizbeth Guilbert
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  6. Omar Espinosa
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  7. Carlos Zerrweck
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Correspondence to Carlos Zerrweck.

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The authors declare that they have no conflict of interest.

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institution and/or national research committee and with 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

Informed Consent

Informed consent was obtained for all individual participants included in the study.

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Pineda, O., Maydón, H.G., Amado, M. et al. A Prospective Study of the Conservative Management of Asymptomatic Preoperative and Postoperative Gallbladder Disease in Bariatric Surgery. OBES SURG 27, 148–153 (2017). https://doi.org/10.1007/s11695-016-2264-3

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  • DOI: https://doi.org/10.1007/s11695-016-2264-3

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