D’Hondt M et al. – Symptomatic gallstone disease occurred only in 6.9% of patients post–laparoscopic Roux–en–Y gastric bypass (LRYGBP). Multivariate analysis identified weight loss at 3 months post–LRYGBP of more than 50% of excess weight as the sole significant independent predictor of delayed symptomatic cholecystolithiasis. Prophylactic cholecystectomy (CCE) should not be recommended at the time of LRYGBP.Methods
- Between August 2003 and November 2009, 724 patients underwent LRYGBP at the Groeninge Hospital.
- Preoperative ultrasound was performed in 600 of 641 patients without history of CCE and 120 (20.0%) were diagnosed with cholecystolithiasis.
- 625 patients were included, 43(6.9%) developed delayed symptoms related to biliary disease.
- Of these 43 patients, 39 underwent post-LRYGBP CCE.
- Of these 39 patients, 9 (7.5%) had a positive ultrasound prior to LRYGBP.
- Multivariate analysis identified weight loss at 3 months post-LRYGB of more than 50% of excess weight [HR (95% CI), 2.04 (1.04–4.28); p=0.037) as the sole significant independent predictor of delayed symptomatic cholecystolithiasis.