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Title: Gallstone Disease After Laparoscopic Sleeve Gastrectomy in an Asian Population—What Proportion of Gallstones Actually Becomes Symptomatic?
Authors: Hasan M.Y.
Lomanto D. 
Loh L.L.
So J.B.Y. 
Shabbir A. 
Keywords: Bariatric surgery
Gastric restrictive procedure
Ursodeoxycholic acid
Weight management
Issue Date: 1-Sep-2017
Publisher: Springer New York LLC
Citation: Hasan M.Y., Lomanto D., Loh L.L., So J.B.Y., Shabbir A. (2017-09-01). Gallstone Disease After Laparoscopic Sleeve Gastrectomy in an Asian Population—What Proportion of Gallstones Actually Becomes Symptomatic?. Obesity Surgery 27 (9) : 2419-2423. ScholarBank@NUS Repository.
Abstract: Background: Despite evidence on gallstone disease after laparoscopic sleeve gastrectomy (LSG), there is an existing lack of consensus on practice guidelines, i.e., surveillance and stone-lowering prophylaxis. Available evidence also has a racial bias as western reports predominate current data. Considering the growing popularity of LSG in Asia and the unique Asian anthropometrics, we have attempted to provide a regional perspective by reviewing our LSG database to investigate the epidemiology of this complication. Methods: One hundred two morbidly obese cases were retrospectively reviewed. Abdominal ultrasounds were conducted preoperatively and at 12-month post-op. No gallstone-lowering prophylaxis was used. Outcome measure was the incidence of new gallstone formation at 1 year and the rate of symptomatic stones during the follow-up period. Results: Mean age was 43 years (range 20–68) with average initial BMI of 41.68 kg/m2. Preoperative gallstones were present in 14 (13.7%) cases. At 12-month post-op, 24 (27.5%) patients with no previous gallstone disease developed new stones. Within the mean follow-up period of 28.4 months, only one case (0.9%) developed gallstone complication requiring a cholecystectomy. We found no statistical difference in demographics, BMI variables (initial BMI, ΔBMI at 6 months and 1 year), and comorbidities between patients with new gallstone and those without stones. Conclusion: Our results match western data in that gallstone formation is common after LSG though incidence of complicated stones is small. This is despite not using gallstone-lowering prophylaxis. The low conversion rate also questions the relevance of surveillance screening, as most patients with new gallstones remain asymptomatic at least in the short-term follow-up. © 2017, Springer Science+Business Media New York.
Source Title: Obesity Surgery
ISSN: 09608923
DOI: 10.1007/s11695-017-2657-y
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