TY - JOUR
T1 - Risk Factors for Symptomatic Gallstone Disease and Gallstone Formation After Bariatric Surgery
AU - Haal, Sylke
AU - Guman, Maimoena S. S.
AU - Bruin, Sjoerd
AU - Schouten, Ruben
AU - van Veen, Ruben N.
AU - Fockens, Paul
AU - Dijkgraaf, Marcel G. W.
AU - Hutten, Barbara A.
AU - Gerdes, Victor E. A.
AU - Voermans, Rogier P.
N1 - Funding Information: This study was funded by the Netherlands Organization for Health Research and Development (grant number 848015003), Zambon Netherlands BV, Foundation for Clinical Research of the Slotervaart Hospital, Spaarne Gasthuis Academy, and Amsterdam Gastroenterology Endocrinology Metabolism. Publisher Copyright: © 2022, The Author(s).
PY - 2022/4
Y1 - 2022/4
N2 - Purpose: Patients who undergo bariatric surgery are at risk for developing cholesterol gallstones. We aimed to identify risk factors that are associated with symptomatic gallstone disease and gallstone formation after bariatric surgery. Materials and Methods: We included participants of the UPGRADE trial, a multicenter randomized placebo-controlled trial on the prevention of symptomatic gallstone disease with ursodeoxycholic acid (UDCA) after bariatric surgery. The association between patient characteristics and symptomatic gallstone disease, and gallstone formation was evaluated using logistic regression analysis. Results: Of 959 patients, 78 (8%) developed symptomatic gallstone disease within 24 months. Risk factors were the presence of a pain syndrome (OR 2.07; 95% CI 1.03 to 4.17) and asymptomatic gallstones before surgery (OR 3.15; 95% CI 1.87 to 5.33). Advanced age (OR 0.95; 95% CI 0.93 to 0.97) was protective, and UDCA prophylaxis did not reach statistical significance (OR 0.64; 95% CI 0.39 to 1.03). No risk factors were identified for gallstone formation, whereas advanced age (OR 0.98; 95% CI 0.96 to 1.00), statin use (OR 0.42; 95% CI 0.20 to 0.90), and UDCA prophylaxis (OR 0.47; 95% CI 0.30 to 0.73) all reduced the risk. Conclusion: Young patients with a preoperative pain syndrome and/or asymptomatic gallstones before bariatric surgery are at increased risk for symptomatic gallstone disease after surgery. Whether statins, either alone or in combination with UDCA prophylaxis, can further reduce the burden of gallstones after bariatric surgery should be investigated prospectively. Graphical abstract: [Figure not available: see fulltext.]
AB - Purpose: Patients who undergo bariatric surgery are at risk for developing cholesterol gallstones. We aimed to identify risk factors that are associated with symptomatic gallstone disease and gallstone formation after bariatric surgery. Materials and Methods: We included participants of the UPGRADE trial, a multicenter randomized placebo-controlled trial on the prevention of symptomatic gallstone disease with ursodeoxycholic acid (UDCA) after bariatric surgery. The association between patient characteristics and symptomatic gallstone disease, and gallstone formation was evaluated using logistic regression analysis. Results: Of 959 patients, 78 (8%) developed symptomatic gallstone disease within 24 months. Risk factors were the presence of a pain syndrome (OR 2.07; 95% CI 1.03 to 4.17) and asymptomatic gallstones before surgery (OR 3.15; 95% CI 1.87 to 5.33). Advanced age (OR 0.95; 95% CI 0.93 to 0.97) was protective, and UDCA prophylaxis did not reach statistical significance (OR 0.64; 95% CI 0.39 to 1.03). No risk factors were identified for gallstone formation, whereas advanced age (OR 0.98; 95% CI 0.96 to 1.00), statin use (OR 0.42; 95% CI 0.20 to 0.90), and UDCA prophylaxis (OR 0.47; 95% CI 0.30 to 0.73) all reduced the risk. Conclusion: Young patients with a preoperative pain syndrome and/or asymptomatic gallstones before bariatric surgery are at increased risk for symptomatic gallstone disease after surgery. Whether statins, either alone or in combination with UDCA prophylaxis, can further reduce the burden of gallstones after bariatric surgery should be investigated prospectively. Graphical abstract: [Figure not available: see fulltext.]
KW - Gallstone formation
KW - Risk factors
KW - Symptomatic gallstone disease
UR - http://www.scopus.com/inward/record.url?scp=85124531297&partnerID=8YFLogxK
U2 - https://doi.org/10.1007/s11695-022-05947-8
DO - https://doi.org/10.1007/s11695-022-05947-8
M3 - Article
C2 - 35143012
SN - 0960-8923
VL - 32
SP - 1270
EP - 1278
JO - Obesity Surgery
JF - Obesity Surgery
IS - 4
ER -