The incidence of gall stones after bariatric surgery and its association with weight loss

Introduction: Gallstone (GS) formation is common in obese patients, particularly during rapid weight loss. This study aimed to determine the incidence of GS in patients underwent bariatric surgery (BS) and the influence of weight loss on GS formation. Methods: This was a prospective study including 148 consecutive patients underwent BS. Patients with preoperative negative abdominal ultrasound (US) for GS were followed-up for at least 12 months. Patients underwent abdominal ultrasound (US) at 3, 6, 9 and 12 months and were clinically screened for symptomatic or complicated cholelithiasis. No GS lowering prophylaxis was used. Clinical and demographic characteristics were compared at baseline and 12 months after surgery. Results: At time of surgery GS was found in 40.6% of the studied patients and history of previous laparoscopic cholecystectomy (LC) was in 6.8% of the studied patients. The incidence of post bariatric GS at 12 months was 22.7% with significant difference (P-value<0.05), (Laparoscopic Sleeve Gastrectomy (LSG): 18.8%, Single anastomosis sleeve ileal bypass (SASI): 33.3%, Mini Gastric Bypass (MGB): 40%, LRYGB 50%). BS operations, rapid weight loss and gastro esophageal reflux disease (GERD) patients are at a higher risk for GS. Conclusions: The incidence of post bariatric GS at 12 months was high (22.7%) with significant difference and we recommend routine US every 3, 6, 9 and 12 months during the first year after BS.