TY - JOUR
T1 - Risk Factors for Cholecystectomy After Laparoscopic Roux-En-Y Gastric Bypass
AU - Haal, Sylke
AU - Rondagh, Djoeke
AU - Hutten, Barbara A.
AU - Acherman, Yair I. Z.
AU - van de Laar, Arnold W. J. M.
AU - Huijgen, Roeland
AU - Gerdes, Victor E. A.
AU - Voermans, Rogier P.
PY - 2020/2/1
Y1 - 2020/2/1
N2 - Background: Patients who have undergone bariatric surgery are at risk for subsequent cholecystectomy. We aimed to identify risk factors for cholecystectomy after laparoscopic Roux-en-Y gastric bypass (LRYGB). Methods: We conducted a retrospective case-control study of patients who underwent LRYGB between 2013 and 2015. Cases underwent cholecystectomy because of biliary symptoms after LRYGB. For each case, two controls were selected without subsequent cholecystectomy. Logistic regression analyses were used to identify risk factors. Results: Between 2013 and 2015, 1780 primary LRYGBs were performed. We identified 233 (13.1%) cases who had undergone cholecystectomy after a median (IQR) of 12 (8–17) months, and 466 controls. Female gender (OR (95% CI) 1.83 (1.06–3.17)), Caucasian ethnicity (OR (95% CI) 1.82 (1.10–3.02)), higher percent total weight loss (%TWL) at 12 months (OR (95% CI) 1.06 (1.04–1.09)), and preoperative pain syndrome (OR (95% CI) 2.72 (1.43–5.18)) were significantly associated with an increased risk for cholecystectomy. Older age (OR (95% CI) 0.98 (0.96–0.99)) and preoperative statin use were associated with a reduced risk (OR (95% CI) 0.56 (0.31–1.00)). A dose-effect relationship was found between the intensity of preoperative statin and risk for cholecystectomy. Conclusions: In our study, higher %TWL and preoperative pain syndrome were associated with an increased risk for cholecystectomy besides the traditional risk factors female gender and Caucasian ethnicity. These factors can be used to identify high-risk patients, who might benefit from preventive measures. Whether statins can protect bariatric patients from developing gallstones should be investigated prospectively.
AB - Background: Patients who have undergone bariatric surgery are at risk for subsequent cholecystectomy. We aimed to identify risk factors for cholecystectomy after laparoscopic Roux-en-Y gastric bypass (LRYGB). Methods: We conducted a retrospective case-control study of patients who underwent LRYGB between 2013 and 2015. Cases underwent cholecystectomy because of biliary symptoms after LRYGB. For each case, two controls were selected without subsequent cholecystectomy. Logistic regression analyses were used to identify risk factors. Results: Between 2013 and 2015, 1780 primary LRYGBs were performed. We identified 233 (13.1%) cases who had undergone cholecystectomy after a median (IQR) of 12 (8–17) months, and 466 controls. Female gender (OR (95% CI) 1.83 (1.06–3.17)), Caucasian ethnicity (OR (95% CI) 1.82 (1.10–3.02)), higher percent total weight loss (%TWL) at 12 months (OR (95% CI) 1.06 (1.04–1.09)), and preoperative pain syndrome (OR (95% CI) 2.72 (1.43–5.18)) were significantly associated with an increased risk for cholecystectomy. Older age (OR (95% CI) 0.98 (0.96–0.99)) and preoperative statin use were associated with a reduced risk (OR (95% CI) 0.56 (0.31–1.00)). A dose-effect relationship was found between the intensity of preoperative statin and risk for cholecystectomy. Conclusions: In our study, higher %TWL and preoperative pain syndrome were associated with an increased risk for cholecystectomy besides the traditional risk factors female gender and Caucasian ethnicity. These factors can be used to identify high-risk patients, who might benefit from preventive measures. Whether statins can protect bariatric patients from developing gallstones should be investigated prospectively.
KW - Cholecystectomy
KW - Gallstones
KW - Risk factors
KW - Roux-en-Y gastric bypass
UR - http://www.scopus.com/inward/record.url?scp=85075374013&partnerID=8YFLogxK
U2 - https://doi.org/10.1007/s11695-019-04166-y
DO - https://doi.org/10.1007/s11695-019-04166-y
M3 - Article
C2 - 31745862
SN - 0960-8923
VL - 30
SP - 507
EP - 514
JO - Obesity Surgery
JF - Obesity Surgery
IS - 2
ER -