title: Complicated gallstones after laparoscopic sleeve gastrectomy.
abstract: BACKGROUND
  The natural history of gallstone formation after laparoscopic sleeve gastrectomy (LSG), the incidence of symptomatic gallstones, and timing of cholecystectomy are not well established.
  
  
  METHODS
  A retrospective review of prospectively collected database of 150 patients that underwent LSG was reviewed.
  
  
  RESULTS
  Preoperatively, gallbladder disease was identified in 32 of the patients (23.2%). Postoperatively, eight of 138 patients (5.8%) became symptomatic. Namely, three of 23 patients (13%) who had evident cholelithiasis preoperatively developed complicated cholelithiasis. From the cohort of patients without preoperative cholelithiasis, five of 106 patients (4.7%) experienced complicated gallstones after LSG. Total cumulative incidence of complicated gallstones was 4.7% (95% CI: 1.3-8.1%). The gallbladder disease-free survival rate was 92.2% at 2 years. No patient underwent cholecystectomy earlier than 9 months or later than 23 months indicating the post-LSG effect.
  
  
  CONCLUSIONS
  A significant proportion of bariatric patients compared to the general population became symptomatic and soon developed complications after LSG, thus early cholecystectomy is warranted. Routine concomitant cholecystectomy could be considered because the proportion of patients who developed complications especially those with potentially significant morbidities is high and the time to develop complications is short and because of the real technical difficulties during subsequent cholecystectomy.
authors.affiliation: Department of Surgery, University Hospital of Larissa, Viopolis, 41110 Larissa, Greece.
authors.forename: Eleni
authors.initials: E
authors.lastname: Sioka
authors.affiliation: Department of Surgery, University Hospital of Larissa, Viopolis, 41110 Larissa, Greece.
authors.forename: Dimitris
authors.initials: D
authors.lastname: Zacharoulis
authors.affiliation: Department of Surgery, University Hospital of Larissa, Viopolis, 41110 Larissa, Greece.
authors.forename: Eleni
authors.initials: E
authors.lastname: Zachari
authors.affiliation: Department of Surgery, University Hospital of Larissa, Viopolis, 41110 Larissa, Greece.
authors.forename: Dimitris
authors.identifier: 0000-0001-5044-1515
authors.initials: D
authors.lastname: Papamargaritis
authors.affiliation: Department of Surgery, University Hospital of Larissa, Viopolis, 41110 Larissa, Greece.
authors.forename: Ourania
authors.identifier: 0000-0003-0758-0936
authors.initials: O
authors.lastname: Pinaka
authors.affiliation: Department of Surgery, University Hospital of Larissa, Viopolis, 41110 Larissa, Greece.
authors.forename: Georgia
authors.initials: G
authors.lastname: Katsogridaki
authors.affiliation: Department of Surgery, University Hospital of Larissa, Viopolis, 41110 Larissa, Greece.
authors.forename: George
authors.initials: G
authors.lastname: Tzovaras
mesh_terms: D000328:Adult; D002763:Cholecystectomy / Q000379:methods*; D002769:Cholelithiasis / Q000453:epidemiology* / Q000209:etiology; D004198:Disease Susceptibility; D005260:Female; D005500:Follow-Up Studies; D005743:Gastrectomy / Q000009:adverse effects* / Q000379:methods*; D006801:Humans; D015994:Incidence; D010535:Laparoscopy; D008297:Male; D008875:Middle Aged; D009767:Obesity, Morbid / Q000150:complications / Q000601:surgery*; D018579:Patient Selection; D011178:Postgastrectomy Syndromes / Q000000981:diagnostic imaging / Q000517:prevention & control* / Q000601:surgery; D012189:Retrospective Studies; D012307:Risk Factors; D013997:Time Factors; D014463:Ultrasonography
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