Do gallstones found before sleeve gastrectomy behave the same as those formed after surgery due to weight loss?
BACKGROUND
Gallstone formation is prevalent in the bariatric population and after weight loss. We believe that gallstones found preoperatively behave differently and may not cause significant complications as those developing after weight loss. Thus, prophylactic cholecystectomy before or during sleeve gastrectomy (SG) may not be necessary.


METHODS
Patients undergoing SG from January 2011 to May 2012 were evaluated for the presence of gallstones and development of symptoms or need for cholecystectomy postoperatively.


RESULTS
Group 1 (n = 18) had gallstones preoperatively. Group 2 (n = 29) developed gallstones after weight loss. Both groups' demographics were similar. Symptomatic gallstones occurred in 1 patient (5.6%) in group 1 and in 9 patients (31.0%) in group 2 (P = .19). Percent excess body mass index loss (%EBL) was 58 ± 24% vs 70 ± 22% (P = .11) with a mean follow-up of 8.9 ± 6.2 and 14.7 ± 3.9 months for group 1 and group 2, respectively (P = .005).


CONCLUSIONS
Asymptomatic gallstones found before SG tend to have less risk of becoming symptomatic than those formed after weight loss. There was no statistical significant difference because of small sample. Prophylactic cholecystectomy, however, may not be warranted in these patients.
Department of Surgery, St John Hospital and Medical Center, 29000 Little Mack Avenue, St Clair Shores, Detroit, MI 48081, USA.
Alexandria
A
Conley
Department of Surgery, St John Hospital and Medical Center, 29000 Little Mack Avenue, St Clair Shores, Detroit, MI 48081, USA.
Moayad
M
Tarboush
Department of Internal Medicine, St John Hospital and Medical Center, Detroit, MI, USA.
Wuttiporn
W
Manatsathit
Department of Surgery, St John Hospital and Medical Center, 29000 Little Mack Avenue, St Clair Shores, Detroit, MI 48081, USA; Department of Surgery, Beaumont Hospital, Grosse Pointe, MI, USA.
Ahmed
A
Meguid
Department of Graduate Medical Education, St John Hospital and Medical Center, Detroit, MI, USA.
Suzanna
S
Szpunar
Department of Surgery, St John Hospital and Medical Center, 29000 Little Mack Avenue, St Clair Shores, Detroit, MI 48081, USA; Department of Surgery, Beaumont Hospital, Grosse Pointe, MI, USA. Electronic address: eastsidesurgical@aol.com.
Abdelkader
A
Hawasli
D000328:Adult; D000704:Analysis of Variance; D015992:Body Mass Index; D002763:Cholecystectomy / Q000379:methods; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D042882:Gallstones / Q000000981:diagnostic imaging* / Q000503:physiopathology / Q000601:surgery; D005743:Gastrectomy / Q000009:adverse effects / Q000379:methods*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009767:Obesity, Morbid / Q000175:diagnosis / Q000601:surgery*; D011300:Preoperative Care / Q000379:methods; D011446:Prospective Studies; D018570:Risk Assessment; D012720:Severity of Illness Index; D016896:Treatment Outcome; D018608:Ultrasonography, Doppler; D015431:Weight Loss
Gallstones; Prophylactic cholecystectomy; Sleeve gastrectomy; Symptomatic