The problem of gallstone disease development in patients undergoing bariatric surgery
https://doi.org/10.17238/2072-3180-2023-19-28
Abstract
Introduction. Bariatric surgery is recognized as a highly effective and safe treatment for obesity and comorbid conditions. Nevertheless the postoperative period is associated with the risk of a number of complications, including gallstone disease (GSD). The reason of GSD is rapid weight loss due to surgical intervention. Currently, there are no standardized schemes for the prevention of cholelithiasis in bariatric patients. Moreover, sometimes implementation of this prevention remains the subject of discussion.
Aim. To present a literature review on the epidemiology of GBD and measures for its prevention after various types of bariatric interventions.
Materials and methods. The analysis of domestic and foreign literary sources appropriate for a given purpose on available Internet resources was carried out. More than 50 scientific publications were studied, 27 of them are listed in this article.
Results. The incidence of GSD after bariatric surgery ranges from 6,5 to 38 % (about 25 % on average), symptomatic cholelithiasis – from 3,3 to 17,5 %, the need for cholecystectomy – from 6,2 to 14,7 %. The appointment of UDCA at a dose of 500–600 mg per day for 6 or more months is an effective measure to prevent the development of cholelithiasis after all types of baritary operations. Prophylactic cholecystectomy is predominantly performed in patients with symptomatic cholelithiasis at the preoperative stage.
About the Authors
A. E. Neimark
«Almazov National Medical Research Centre» of the Ministry of Health of the Russian Federation; The Federal State Budgetary Institution "North-Western district scientific and clinical center named after L. G. Sokolov Federal Medical and Biological Agency"
Russian Federation
Russian Federation
Neimark Aleksandr Evgenyevich – Candidate of Medical Sciences, Associate Professor, Head of the Laboratory of the Research Laboratory for Surgery of Metabolic Disorders, Leading Researcher, Surgeon; surgeon, gastroenterological center «Expert»
197341, st. Akkuratova 2, St. Petersburg
197110, st. Pionerskaya, 16, St. Petersburg
S. N. Mekhtiev
The Federal State Budgetary Institution "North-Western district scientific and clinical center named after L. G. Sokolov Federal Medical and Biological Agency"
Russian Federation
Russian Federation
Mekhtiev Sabir Nasredinovich – Doctor of Medical Sciences, Professor of the Department of Hospital Therapy with a Course of Allergology and Immunology named after Academician M.V. Chernorutsky with the clinic, First St. Petersburg State Medical University named after Academician I.P. Pavlova; Chairman of the Hepatosection of the St. Petersburg Society of Therapists named after S.P. Botkin; chief physician, gastroenterological center «Expert»
197022, st. Leo Tolstoy, 6–8, St. Petersburg
197110, st. Pionerskaya, 16, St. Petersburg
O. V. Kornyushin
«Almazov National Medical Research Centre» of the Ministry of Health of the Russian Federation
Russian Federation
Russian Federation
Kornyushin Oleg Viktorovich – Candidate of Medical Sciences, Leading Researcher at the Research Laboratory for Surgical Correction of Metabolic Disorders, Senior Researcher at the Research Laboratory of Myocardial Metabolism, Surgeon
197341, st. Akkuratova 2, St. Petersburg
O. M. Berko
The Federal State Budgetary Institution "North-Western district scientific and clinical center named after L. G. Sokolov Federal Medical and Biological Agency"
Russian Federation
Russian Federation
Berko Olesya Mikhailovna – gastroenterologist
194291, Avenue of Culture 4, St. Petersburg
References
1. Di Ciaula A., Wang D.Q., Portincasa P. An update on the pathogenesis of cholesterol gallstone disease. Curr Opin Gastroenterol, 2018, № 34(2), pp. 71–80. https://doi.org/10.1097/MOG.0000000000000423
2. European Association for the Study of the Liver (EASL). EASL Clinical Practice Guidelines on the prevention, diagnosis and treatment of gallstones. J Hepatol, 2016, № 65(1), рр. 146–181. https://doi.org/10.1016/j.jhep.2016.03.005
3. Guman M.S.S., Hoozemans J.B., Haal S., de Jonge P.A., Aydin Ö., Lappa D., Meijnikman A.S., Westerink F., Acherman Y., Bäckhed F., de Brauw M., Nielsen J., Nieuwdorp M., Groen A.K., Gerdes V.E.A. Adipose Tissue, Bile Acids, and Gut Microbiome Species Associated With Gallstones After Bariatric Surgery. J Lipid Res, 2022, № 63(11), р. 100280. https://doi.org/10.1016/j.jlr.2022.100280
4. Haal S., Guman M.S.S., Acherman Y.I.Z., Jansen J.P.G., van Weeghel M., van Lenthe H., Wever E.J.M., Gerdes V.E.A., Voermans R.P., Groen A.K. Gallstone Formation Follows a Different Trajectory in Bariatric Patients Compared to Nonbariatric Patients. Metabolites, 2021, № 11(10), р. 682. https://doi.org/10.3390/metabo11100682
5. Loranskaja I.D., Vishnevskaja V.V. The study of the motor function of the biliary system and gastroduodenal zone in the pathology of the biliary tract. RMJ, 2005, № 1, p. 1. (In Russ.)
6. Melmer A., Sturm W., Kuhnert B., Engl-Prosch J., Ress C., Tschoner A., Laimer M., Laimer E., Biebl M., Pratschke J., Tilg H., Ebenbichler C. Incidence of Gallstone Formation and Cholecystectomy 10 Years After Bariatric Surgery. Obes Surg, 2015, № 25(7), рр. 1171–1176. https://doi.org/10.1007/s11695-014-1529-y
7. Magouliotis D.E., Tasiopoulou V.S., Svokos A.A., Svokos K.A., Chatedaki C., Sioka E., Zacharoulis D. Ursodeoxycholic Acid in the Prevention of Gallstone Formation After Bariatric Surgery: an Updated Systematic Review and Meta-analysis. Obes Surg, 2017, № 27(11), рр. 3021–3030. https://doi.org/10.1007/s11695-017-2924-y
8. Aldriweesh M.A., Aljahdali G.L., Shafaay E.A., Alangari D.Z., Alhamied N.A., Alradhi H.A., Yaqoub A.S., El-Boghdadly S., Aldibasi O.S., Adlan A.A. The Incidence and Risk Factors of Cholelithiasis Development After Bariatric Surgery in Saudi Arabia: A Two-Center Retrospective Cohort Study. Front Surg, 2020, № 7, р. 559064. https://doi.org/10.3389/fsurg.2020.559064
9. Talha A., Abdelbaki T., Farouk A., Hasouna E., Azzam E., Shehata G. Cholelithiasis after bariatric surgery, incidence, and prophylaxis: randomized controlled trial. Surg Endosc, 2020, № 34(12), рр. 5331–5337. https://doi.org/10.1007/s00464-019-07323-7
10. Guzmán H.M., Sepúlveda M., Rosso N., San Martin A., Guzmán F., Guzmán H.C. Incidence and Risk Factors for Cholelithiasis After Bariatric Surgery. Obes Surg, 2019, № 29(7), рр. 2110–2114. https://doi.org/10.1007/s11695-019-03760-4
11. Fearon N.M., Kearns E.C., Kennedy C.A., Conneely J.B., Heneghan H.M. The impact of ursodeoxycholic acid on gallstone disease after bariatric surgery: a meta-analysis of randomized control trials. Surg Obes Relat Dis, 2022, № 18(1), рр. 77–84. https://doi.org/10.1016/j.soard.2021.10.004
12. Chen J.H., Tsai M.S., Chen C.Y., Lee H.M., Cheng C.F., Chiu Y.T., Yin W.Y., Lee C.H. Bariatric Surgery Did Not Increase the Risk of Gallstone Disease in Obese Patients: a Comprehensive Cohort Study. Obes Surg, 2019, № 29(2), рр. 464-473. https://doi.org/10.1007/s11695-018-3532-1
13. Sneineh M.A., Harel L., Elnasasra A., Razin H., Rotmensh A., Moscovici S., Kais H., Shirin H. Increased Incidence of Symptomatic Cholelithiasis After Bariatric Roux-En-Y Gastric Bypass and Previous Bariatric Surgery: a Single Center Experience. Obes Surg, № 30(3), рр. 846–850. https://doi.org/10.1007/s11695-019-04366-6
14. Morais M., Faria G., Preto J., Costa-Maia J. Gallstones and Bariatric Surgery: To Treat or Not to Treat? World J Surg, 2016, № 40(12), рр. 2904–2910. https://doi.org/10.1007/s00268-016-3639-2
15. Della Penna A., Lange J., Hilbert J., Archid R., Königsrainer A., Quante M. Ursodeoxycholic Acid for 6 Months After Bariatric Surgery Is Impacting Gallstone Associated Morbidity in Patients with Preoperative Asymptomatic Gallstones. Obes Surg, 2019, № 29(4), рр. 1216–1221. https://doi.org/10.1007/s11695-018-03651-0
16. Alsaif F.A., Alabdullatif F.S., Aldegaither M.K., Alnaeem K.A., Alzamil A.F., Alabdulkarim N.H., Aldohayan A.D. Incidence of symptomatic cholelithiasis after laparoscopic sleeve gastrectomy and its association with rapid weight loss. Saudi J Gastroenterol, 2020, № 26(2), рр. 94–98. https://doi.org/10.4103/sjg.SJG_472_19
17. Anveden Å., Peltonen M., Näslund I., Torgerson J., Carlsson L.M.S. Long-term incidence of gallstone disease after bariatric surgery: results from the nonrandomized controlled Swedish Obese Subjects study. Surg Obes Relat Dis, 2020, № 16(10), рр. 1474–1482. https://doi.org/10.1016/j.soard.2020.05.025
18. Tsirline V.B., Keilani Z.M., El Djouzi S., Phillips R.C., Kuwada T.S., Gersin K., Simms C., Stefanidis D. How frequently and when do patients undergo cholecystectomy after bariatric surgery? Surg Obes Relat Dis, 2014, № 10(2), рр. 313–321. https://doi.org/10.1016/j.soard.2013.10.011
19. Ying J., Dai S., Fu R., Hong J., Dai C., Jin Q. Effect of ursodeoxycholic acid on gallstone formation after bariatric surgery: An updated metaanalysis. Obesity (Silver Spring), 2022, № 30(6), рр. 1170–1180. https://doi.org/10.1002/oby.23427
20. Mulliri A., Menahem B., Alves A., Dupont B. Ursodeoxycholic acid for the prevention of gallstones and subsequent cholecystectomy after bariatric surgery: a meta-analysis of randomized controlled trials. J Gastroenterol, 2022, № 57(8), рр. 529–539. https://doi.org/10.1007/s00535-022-01886-4
21. Han M.L., Lee M.H., Lee W.J., Chen S.C., Almalki O.M., Chen J.C., Wu C.C. Probiotics for gallstone prevention in patients with bariatric surgery: A prospective randomized trial. Asian J Surg, 2022, № 45(12), рр. 2664–2669. https://doi.org/10.1016/j.asjsur.2022.01.120
22. Haal S., Guman M.S.S., Boerlage T.C.C., Acherman Y.I.Z., de Brauw L.M., Bruin S., de Castro S.M.M., van Hooft J.E., van de Laar A.W.J.M., Moes D.E., Schouten M., Schouten R., van Soest E.J., van Veen R.N., de Vries C.E.E., Fockens P., Dijkgraaf M.G.W., Gerdes V.E.A., Voermans R.P. Ursodeoxycholic acid for the prevention of symptomatic gallstone disease after bariatric surgery (UPGRADE): a multicentre, double-blind, randomised, placebo-controlled superiority trial. Lancet Gastroenterol Hepatol, 2021, № 6(12), рр. 993–1001. https://doi.org/10.1016/S2468-1253(21)00301-0
23. De Luca M., Angrisani L., Himpens J., Busetto L., Scopinaro N., Weiner R., Sartori A., Stier C., Lakdawala M., Bhasker A.G., Buchwald H., Dixon J., Chiappetta S., Kolberg H.C., Frühbeck G., Sarwer D.B., Suter M., Soricelli E., Blüher M., Vilallonga R., Sharma A., Shikora S. Indications for Surgery for Obesity and Weight-Related Diseases: Position Statements from the International Federation for the Surgery of Obesity and Metabolic Disorders (IFSO). Obes Surg, 2016, № 26(8), рр. 1659–1696. https://doi.org/10.1007/s11695-016-2271-4
24. Mechanick JI, Apovian C, Brethauer S, et al. Clinical practice guidelines for the perioperative nutrition, metabolic, and nonsurgical support of patients undergoing bariatric procedures – 2019 update: cosponsored by American Association of Clinical Endocrinologists/ American College of Endocrinology, The Obesity Society, American Society for Metabolic & Bariatric Surgery, Obesity Medicine Association, and American Society of Anesthesiologists – executive summary. Endocr Pract, 2019, № 25(12), рр. 1346–1359. https://doi.org/10.4158/GL-2019-0406
25. Di Lorenzo N., Antoniou S.A., Batterham R.L., Busetto L., Godoroja D., Iossa A., Carrano F.M., Agresta F., Alarçon I., Azran C., Bouvy N., Balaguè Ponz C., Buza M., Copaescu C., De Luca M., Dicker D., Di Vincenzo A., Felsenreich D.M., Francis N.K., Fried M., Gonzalo Prats B., Goitein D., Halford J.C.G., Herlesova J., Kalogridaki M., Ket H., Morales-Conde S., Piatto G., Prager G., Pruijssers S., Pucci A., Rayman S., Romano E., SanchezCordero S., Vilallonga R., Silecchia G. Clinical practice guidelines of the European Association for Endoscopic Surgery (EAES) on bariatric surgery: update 2020 endorsed by IFSO-EC, EASO and ESPCOP. Surg Endosc, 2020, № 34(6), рр. 2332–2358. https://doi.org/10.1007/s00464-020-07555-y
26. Stenberg E., Dos Reis Falcão L.F., O’Kane M., Liem R., Pournaras D.J., Salminen P., Urman R.D., Wadhwa A., Gustafsson U.O., Thorell A. Guidelines for Perioperative Care in Bariatric Surgery: Enhanced Recovery After Surgery (ERAS) Society Recommendations: A 2021 Update. World J Surg, 2022, № 46(4), рр. 729–751. https://doi.org/10.1007/s00268-02106394-9
27. Eisenberg D., Shikora S.A., Aarts E., Aminian A., Angrisani L., Cohen R.V., De Luca M., Faria S.L., Goodpaster K.P.S., Haddad A., Himpens J.M., Kow L., Kurian M., Loi K., Mahawar K., Nimeri A., O’Kane M., Papasavas P.K., Ponce J., Pratt J.S.A., Rogers A.M., Steele K.E., Suter M., Kothari S.N. 2022 American Society for Metabolic and Bariatric Surgery (ASMBS) and International Federation for the Surgery of Obesity and Metabolic Disorders (IFSO): Indications for Metabolic and Bariatric Surgery. Surg Obes Relat Dis, 2022, № 18(12), рр. 1345–1356. https://doi.org/10.1016/j.soard.2022.08.013
Review
For citations:
Neimark A.E., Mekhtiev S.N., Kornyushin O.V., Berko O.M. The problem of gallstone disease development in patients undergoing bariatric surgery. Moscow Surgical Journal. 2023:19-28. (In Russ.) https://doi.org/10.17238/2072-3180-2023-19-28
Views:
361
Email this article 