The fate of the gallbladder in patients admitted to bariatric surgery

Abstract

Aim: Obesity has become a rapidly increasing public health problem all over the world. Obesity itself is a risk factor for cholelithiasis, and the fast weight loss period after bariatric surgery is a situation that increases this risk. The fact that both obesity and surgical treatment of obesity increases the formation of stones in the gall bladder has made it even defendible that cholecystectomy should be performed routinely during the bariatric surgery at one stage, even if there is no cholelithiasis. In this study, we aimed to evaluate our gallbladder approach in patients who were decided to undergo bariatric surgery in our center, together with the literature reviews. Methods: In our study, the data of 185 patients who underwent bariatric surgery due to obesity in the University of Health Sciences Kanuni Sultan Suleyman the in Istanbul Training and Research Hospital Clinic of, Department of General Surgery, between 2018 and 2020 were retrospectively obtained. A total of 185 patients were included in the study. The patients were divided into group 1 (sleeve gastrectomy) and Group 2 (gastric bypass) according to their operation techniques. Results: The average age was 36.43 ± 9.52, the ratio of women/ men was 151 (81.6%)/34 (18.4%). Mean body mass index (BMI) was determined as 44.16±5.09. In the postoperative period, gallstones were formed in 27 (14.6%) patients, whereas gallstones were not detected in 158 (85.4%) patients. There was no significant difference between the groups in terms of postoperative gallstone formation. Conclusion: In the light of the literature and after our clinical experience, we do not require routine imaging of the gallbladder before bariatric surgery in asymptomatic patients, and we recommend performing concomitant cholecystectomy only in symptomatic patients.