Abstract
Evaluation of the prevalance of cholelithiasis, choledocholithiasis and there management after sleeve gastrectomy, gastric bypass and mini gastric bypass in Indian bariatric patients. We did a retrospective analysis of our bariatric patient from January 2007 to December 2013 (n = 1397), for prevalence of cholelithiasis and choledocholithiasis. We did synchronous cholecystectomy in all patients planned for bariatric surgery found to have cholelithiasis on USG. Post-operatively, we followed all the patients with gallbladder in situ for minimum of 18-88months (mean -32.4) and reviewed data for subsequent development of cholelithiasis/choledocholithiasis. Only those patients who were symptomatic underwent intervention. Prevalence of cholelithiasis and choledocholithiasis in our study was 21.76 and 9.63%, respectively. The incidence of post-bariatric surgery development of cholelithiasis was 10.53%; individually, it was 8.42% in LSG group, 13.4% in LRYGB group and 12.7% in MGB patients. The incidence of symptomatic cholelithiasis requiring surgery was 1.94% after LSG, 4.54% after LRYGB and 4.25% after MGB. Post-surgery, six patients developed choledocholithiasis. In our post-bariatric group, the 33 patients who developed symptomatic stones had percentage total weight loss of 30.99 + 4.1 (P < 0.001). The average time period for readmission of symptomatic patient was 11.26 + 2.67months. We recommend routine synchronous cholecystectomy with bariatric procedure. In spite of synchronous cholecystectomy, incidence of cholelithiasis in our post-bariatric patient is 10.53% of which up to one third were symptomatic and required surgery, and incidence of choledocholithiasis is comparable to that of general population.
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