Incidence and risk factors for de novo cholelithiasis after bariatric surgery

• Published in: Cirugia española (English ed.) 2021-11, Vol.99 (9), p.648-654
• Main Authors: Andrés-Imaz, Ainhoa, Martí-Gelonch, Laura, Eizaguirre-Letamendia, Emma, Asensio-Gallego, José Ignacio, Enríquez-Navascués, José María
• Format: Article
• Language: English
• Subjects: Bariatric surgery; Bariatric Surgery - adverse effects; Cholelithiasis; Cholelithiasis - epidemiology; Cirugía bariátrica; Colelitiasis; Humans; Incidence; Obesidad; Obesity; Obesity, Morbid; Risk Factors; Ursodeoxycholic acid; Ácido ursodesoxicólico
• ISSN: 2173-5077; 2173-5077
• DOI: 10.1016/j.cireng.2021.09.010

[Display omitted] Obesity and rapid weight loss after bariatric surgery (BS) are risk factors for the development of cholelitiasis. The aim of this study is to know the incidence of the de novo symptomatic cholelitiasis (DNSC) after BS and to analyze the risk factors for its development. Single-centre retrospective observational study of patients undergoing BS between January 2010 and December 2017. The incidence of DNSC has been studied and sex, age, comorbilities, surgical tecnique, initial BMI and percentage of excess BMI lost (%EBMIL) at 6th, 12th and 24th postoperative months have been analyzed. Among the 415 patients who underwent BS, 280 have been studied since they were not previously cholecystectomized and had a preoperative negative abdominal ultrasound. Twenty-nine developed DNSC (10,35%), with a remarkably higher increase in cumulative incidence during the first postoperative year (CI 5%, IC 95% 2,4–7,6). A higher percentage of excess BMI lost at the 6, 12 and 24 postoperative months was statistically significantly correlated with an increased risk of DNSC. Incidence of DNSC and cholecystectomy after BS are relatively high, mainly during rapid weight loss period and even more the higher the percentage of excess BMI lost is. Concomitant cholecystectomy during BS in case of preoperative cholelithiasis regardless of symptoms and the use of ursodeoxycholic acid during the period of greater risk for DNSC development are two therapeutic options to consider. La obesidad y la rápida pérdida de peso tras cirugía bariátrica (CB) son factores de riesgo para la formación de colelitiasis. El objetivo de este trabajo es conocer la incidencia de colelitiasis de novo sintomática (CLNS) tras CB y analizar los factores de riesgo para su desarrollo. Estudio observacional retrospectivo unicéntrico de los pacientes sometidos a CB entre Enero de 2010 y Diciembre de 2017. Se ha estudiado la incidencia de CLNS y se han analizado el género, la edad, las comorbilidades, la técnica quirúrgica, el IMC inicial y el % exceso de IMC perdido (%EIMCP) al 6°, 12° y 24° mes postoperatorio. De los 415 pacientes intervenidos de CB, 280 han sido estudiados ya que no estaban colecistectomizados previamente y tenían una ecografía preoperatoria negativa para colelitiasis. Veintinueve desarrollaron CLNS (10,35%), con un aumento en la incidencia acumulada notablemente más alto durante el primer año postoperatorio (IA 5%, IC 95% 2,4–7,6). Un mayor %EIMCP al 6°, 12°, 24° mes postoperatori