title: Incidence of Gallstone Formation and Cholecystectomy 10 Years After Bariatric Surgery.
abstract: OBJECTIVE
  Rapid weight loss is a risk factor for gallstone formation, and postoperative treatment options for gallstone formation are still part of scientific discussion. No prospective studies monitored the incidence for gallstone formation and subsequent cholecystectomy after bariatric surgery longer than 5 years. The aim of the study was to determine the incidence of gallstone formation and cholecystectomy in bariatric patients over 10 years.
  
  
  METHODS
  One hundred nine patients were observed over 10 years after laparoscopic gastric banding or gastric bypass/gastric sleeve. The incidence of gallstone formation and cholecystectomy was correlated to longitudinal changes in anthropometric parameters.
  
  
  RESULTS
  In total, 91 female and 18 male patients were examined. Nineteen patients had postoperative gallstone formation, and 12 female patients required cholecystectomy. The number needed to harm for gallstone formation was 7.1 and 2.3 cases in the banding group and gastric bypass/gastric sleeve group, respectively. The number needed to harm for cholecystectomy was 11.6 and 2.5 cases in the banding group and the gastric bypass/gastric sleeve group, respectively. Weight loss was higher in patients requiring subsequent cholecystectomy. Mean follow-up to cholecystectomy was 21.5 months with the latest operation after 51 months.
  
  
  CONCLUSIONS
  Female gender and rapid weight loss were major risk factors for postoperative cholelithiasis. Ultrasound examinations within 2 to 5 years are recommended in every patient, independent of bariatric procedure. Pharmacologic treatment should be considered in high risk patients within 2 to 5 years to prevent postoperative cholelithiasis. This helps to optimize patient care and lowers postoperative morbidity.
authors.affiliation: Department of Internal Medicine I, Medical University of Innsbruck, Anichstrasse 35, 6020, Innsbruck, Austria.
authors.forename: Andreas
authors.initials: A
authors.lastname: Melmer
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Sturm
authors.forename: Bernhard
authors.initials: B
authors.lastname: Kuhnert
authors.forename: Julia
authors.initials: J
authors.lastname: Engl-Prosch
authors.forename: Claudia
authors.initials: C
authors.lastname: Ress
authors.forename: Alexander
authors.initials: A
authors.lastname: Tschoner
authors.forename: Markus
authors.initials: M
authors.lastname: Laimer
authors.forename: Elisabeth
authors.initials: E
authors.lastname: Laimer
authors.forename: Matthias
authors.initials: M
authors.lastname: Biebl
authors.forename: Johann
authors.initials: J
authors.lastname: Pratschke
authors.forename: Herbert
authors.initials: H
authors.lastname: Tilg
authors.forename: Christoph
authors.initials: C
authors.lastname: Ebenbichler
mesh_terms: D000328:Adult; D000368:Aged; D050110:Bariatric Surgery / Q000009:adverse effects / Q000706:statistics & numerical data*; D002763:Cholecystectomy / Q000706:statistics & numerical data*; D005260:Female; D042882:Gallstones / Q000453:epidemiology* / Q000209:etiology / Q000601:surgery*; D006801:Humans; D015994:Incidence; D010535:Laparoscopy / Q000009:adverse effects; D008297:Male; D008875:Middle Aged; D009767:Obesity, Morbid / Q000453:epidemiology* / Q000601:surgery*; D011184:Postoperative Period; D011446:Prospective Studies; D012307:Risk Factors; D013997:Time Factors; D015431:Weight Loss / Q000502:physiology