Background Laparoscopic sleeve gastrectomy (LSG) is an effective bariatric procedure for individuals with obesity; however, rapid postoperative weight loss and substantial body mass index (BMI) reductions have been associated with gallstone (cholelithiasis) formation [<CitationRef CitationID="CR1">1</CitationRef>]. This complication may adversely affect postoperative quality of life and overall clinical outcomes. Objective The aim of this study was to investigate the association between early postoperative rapid weight loss, changes in BMI, and the development of gallstones following LSG in a retrospective patient cohort. We also evaluated additional risk factors, including family history, comorbidities, postoperative diet, and lifestyle changes. Methods In this retrospective study, medical records of patients diagnosed with obesity who underwent LSG between January 2022 and December 2023 were reviewed. All participants had a minimum follow-up of 12 months. Clinical evaluations, including anthropometric measurements and abdominal ultrasonography for gallstone detection, were performed at 3, 6, and 12 months postoperatively. Family history data were obtained using a structured questionnaire administered during the preoperative assessment [<CitationRef CitationID="CR2">2</CitationRef>]. Early postoperative weight loss data (recorded at 1, 3, and 6 months) were analyzed to assess its impact on gallstone formation. Results Among the 150 patients included, 13 developed gallstones during the follow-up period, with a median time to diagnosis of 6 months (range: 3–12 months). Patients who developed gallstones had significantly greater weight loss in the early postoperative period compared with those who did not (p < 0.05). Moreover, a positive family history and adherence to a low-calorie, low-fat postoperative diet were independent risk factors for gallstone development. Intraoperative gallstones were detected in 3 patients, who underwent concurrent cholecystectomy and were analyzed separately from the postoperative cases. Conclusion Our findings suggest that rapid early postoperative weight loss and significant BMI reductions are independently associated with an increased risk of gallstone formation following LSG. Regular ultrasonographic screening, dietary management, and, where appropriate, adjunctive treatment with ursodeoxycholic acid [<CitationRef CitationID="CR3">3</CitationRef>] should be considered to mitigate this risk.

The effect of body mass index change on cholelithiasis after laparoscopic sleeve gastrectomy: a single center experience

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2025年8月13日

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Serhat Doğan,
Yunus Dönder

摘要

Background

Laparoscopic sleeve gastrectomy (LSG) is an effective bariatric procedure for individuals with obesity; however, rapid postoperative weight loss and substantial body mass index (BMI) reductions have been associated with gallstone (cholelithiasis) formation [1]. This complication may adversely affect postoperative quality of life and overall clinical outcomes.

Objective

The aim of this study was to investigate the association between early postoperative rapid weight loss, changes in BMI, and the development of gallstones following LSG in a retrospective patient cohort. We also evaluated additional risk factors, including family history, comorbidities, postoperative diet, and lifestyle changes.

Methods

In this retrospective study, medical records of patients diagnosed with obesity who underwent LSG between January 2022 and December 2023 were reviewed. All participants had a minimum follow-up of 12 months. Clinical evaluations, including anthropometric measurements and abdominal ultrasonography for gallstone detection, were performed at 3, 6, and 12 months postoperatively. Family history data were obtained using a structured questionnaire administered during the preoperative assessment [2]. Early postoperative weight loss data (recorded at 1, 3, and 6 months) were analyzed to assess its impact on gallstone formation.

Results

Among the 150 patients included, 13 developed gallstones during the follow-up period, with a median time to diagnosis of 6 months (range: 3–12 months). Patients who developed gallstones had significantly greater weight loss in the early postoperative period compared with those who did not (p < 0.05). Moreover, a positive family history and adherence to a low-calorie, low-fat postoperative diet were independent risk factors for gallstone development. Intraoperative gallstones were detected in 3 patients, who underwent concurrent cholecystectomy and were analyzed separately from the postoperative cases.

Conclusion

Our findings suggest that rapid early postoperative weight loss and significant BMI reductions are independently associated with an increased risk of gallstone formation following LSG. Regular ultrasonographic screening, dietary management, and, where appropriate, adjunctive treatment with ursodeoxycholic acid [3] should be considered to mitigate this risk.