title: Cholecystolithiasis after gastric bypass: a clinical, biochemical, and ultrasonographic 3-year follow-up study.
abstract: BACKGROUND
  Cholecystolithiasis (CL) is a common occurrence after bariatric surgery. Few studies have prospectively analyzed not only gallstone formation after Roux-en-Y gastric bypass (RYGBP), but also its complications and symptoms. This study aimed to identify the incidence of CL itself and symptomatic CL after RYGBP as well as the presence of predictive factors for CL.
  
  
  METHODS
  A prospective observational study was performed on 40 morbidly obese patients free of gallbladder disease undergoing RYGBP at a public hospital in Brazil between February and October 2007. They were followed up clinically, biochemically (lipid profile), and ultrasonographically at 6 months and 1, 2, and 3 years after surgery. Postoperative prophylactic bile salt therapy (ursodiol) was not prescribed. Of the 40 patients, 38 completed the 3-year follow-up. They were divided into two groups: those who formed gallstones and those who did not. These groups were compared with respect to gender, age, preoperative body mass index (BMI) and lipid profile results, and postoperative percentage of excess BMI lost (%EBL) and lipid profile results.
  
  
  RESULTS
  The overall postoperative incidence of CL was 28.9 % (11 out of 38), with a 15.7 % incidence of symptomatic CL (6 out of 38). Gender, age, preoperative BMI, postoperative %EBL, and preoperative and postoperative lipid profile results were not identified as predictive factors for CL after RYGBP.
  
  
  CONCLUSIONS
  There was a high incidence of CL after RYGBP, occurring primarily in the first 2 years postoperatively. There was no identified predictive factor for gallstone formation after RYGBP. Most patients who formed gallstones were symptomatic, some with potentially severe complications.
authors: Department of Surgery, Ipsemg Hospital, Rua Gonçalves Dias 332/1001 Bairro Funcionários, 30140-090, Belo Horizonte, MG, Brazil. rgnagem@yahoo.com.br
authors: Rachid
authors: R
authors: Nagem
authors: Alcino
authors: A
authors: Lázaro-da-Silva
mesh_terms: D000328:Adult; D015992:Body Mass Index; D001938:Brazil / Q000453:epidemiology; D002763:Cholecystectomy / Q000706:statistics & numerical data*; D041761:Cholecystolithiasis / Q000000981:diagnostic imaging / Q000453:epidemiology* / Q000209:etiology / Q000601:surgery; D004198:Disease Susceptibility; D005260:Female; D005500:Follow-Up Studies; D015390:Gastric Bypass / Q000009:adverse effects; D006801:Humans; D015994:Incidence; D008055:Lipids / Q000097:blood; D008297:Male; D008875:Middle Aged; D009767:Obesity, Morbid / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000601:surgery*; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012307:Risk Factors; D013997:Time Factors; D014463:Ultrasonography
chemical_list: D008055:Lipids