Ribeiro Jr MA, Tebar GK, Niero HB, Pacheco LS. Biliary complications associated with weight loss, cholelithiasis and choledocholithiasis. World J Gastrointest Pharmacol Ther 2024; 15(4): 95647 [PMID: 38983103 DOI: 10.4292/wjgpt.v15.i4.95647]
Corresponding Author of This Article
Marcelo A Ribeiro Jr, FAASLD, FACS, MD, PhD, Chief Physician, Full Professor, Researcher, Surgeon, Department of Surgery, Division of Trauma, Critical Care and Acute Care Surgery, Sheikh Shakhbout Medical City, Abu Dhabi 11001, United Arab Emirates. drmribeiro@gmail.com
Research Domain of This Article
Surgery
Article-Type of This Article
Minireviews
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Gastrointest Pharmacol Ther. Jul 5, 2024; 15(4): 95647 Published online Jul 5, 2024. doi: 10.4292/wjgpt.v15.i4.95647
Biliary complications associated with weight loss, cholelithiasis and choledocholithiasis
Marcelo A Ribeiro Jr, Gabriela K Tebar, Helena B Niero, Leticia S Pacheco
Marcelo A Ribeiro Jr, Department of Surgery, Division of Trauma, Critical Care and Acute Care Surgery, Sheikh Shakhbout Medical City, Abu Dhabi 11001, United Arab Emirates
Marcelo A Ribeiro Jr, Helena B Niero, Leticia S Pacheco, Department of Surgery, Pontifical Catholic University of São Paulo-Campus Sorocaba, Sorocaba 18030070, SP, Brazil
Gabriela K Tebar, Department of Surgery, Pontifical Catholic University of São Paulo-Sorocaba, Sorocaba 18030070, SP, Brazil
Author contributions: Ribeiro Jr MA carries out idealisation work, supervises the development of the study, drafts the text and revises the final text; Tebar GK, Niero HB and Pacheco LS carried out the literature review, collaborated on the drafting of the text and the literature review.
Conflict-of-interest statement: The authors have no conflict of interest to declare.
PRISMA 2009 Checklist statement: The authors have read the PRISMA 2009 Checklist, and the manuscript was prepared and revised according to the PRISMA 2009 Checklist.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Marcelo A Ribeiro Jr, FAASLD, FACS, MD, PhD, Chief Physician, Full Professor, Researcher, Surgeon, Department of Surgery, Division of Trauma, Critical Care and Acute Care Surgery, Sheikh Shakhbout Medical City, Abu Dhabi 11001, United Arab Emirates. drmribeiro@gmail.com
Received: April 15, 2024 Revised: May 23, 2024 Accepted: July 1, 2024 Published online: July 5, 2024 Processing time: 79 Days and 19.8 Hours
Abstract
Biliary complications like cholelithiasis and choledocholithiasis are more common in bariatric surgery patients due to obesity and rapid weight loss. Patients with a body mass index > 40 face an eightfold risk of developing cholelithiasis. Post-bariatric surgery, especially after laparoscopic Roux-en-Y gastric bypass (LRYGB), 30% of patients develop biliary disease due to rapid weight loss. The aim of this review is to analyze the main biliary complications that occur after bariatric surgery and its management. A review of the literature was conducted mainly from 2010 up to 2023 with regard to biliary complications associated with bariatric patients in SciELO, PubMed, and MEDLINE. Patients undergoing LRYGB have a higher incidence (14.5%) of symptomatic calculi post-surgery compared to those undergoing laparoscopic sleeve gastrectomy at 4.1%. Key biliary complications within 6 to 12 months post-surgery include: Cholelithiasis: 36%; Biliary colic/dyskinesia: 3.86%; Acute cholecystitis: 0.98%-18.1%; Chronic cholecystitis: 70.2%; Choledocholithiasis: 0.2%-5.7% and Pancreatitis: 0.46%-9.4%. Surgeons need to be aware of these complications and consider surgical treatments based on patient symptoms to enhance their quality of life.
Core Tip: Surgeons performing bariatric surgery should be vigilant about the increased risk of biliary complications in patients, particularly those with a body mass index over 40, as they have an eightfold higher risk of developing cholelithiasis. Monitoring for symptoms and considering individual risk factors can guide appropriate treatment, potentially improving patients' quality of life post-surgery.
