Spectrum and Risk Factors of Complications After Gastric Bypass

Abstract 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.

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A287 Effect of Gastric Bypass and Very-Low Energy Diet on cardiometabolic risk factors

Surgery for Obesity and Related Diseases ◽

10.1016/j.soard.2019.08.232 ◽

2019 ◽

Vol 15 (10) ◽

pp. S114

Author(s):

Line Kristin Johnson ◽

Rune Sandbu ◽

Ida Robertsen ◽

Anders Åsberg ◽

Tommy Andersson ◽

...

Keyword(s):

Risk Factors ◽

Gastric Bypass ◽

Cardiometabolic Risk ◽

Low Energy ◽

Cardiometabolic Risk Factors ◽

Very Low Energy Diet ◽

Low Energy Diet

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Acid-related complications after laparoscopic Roux-en-Y gastric bypass: risk factors and impact of proton pump inhibitors

Surgery for Obesity and Related Diseases ◽

10.1016/j.soard.2020.01.005 ◽

2020 ◽

Vol 16 (5) ◽

pp. 620-625 ◽

Cited By ~ 2

Author(s):

Jeff Wennerlund ◽

Ulf Gunnarsson ◽

Karin Strigård ◽

Magnus Sundbom

Keyword(s):

Risk Factors ◽

Gastric Bypass ◽

Proton Pump Inhibitors ◽

Proton Pump

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P70: Gastric bypass provides long-term improvement in cardiac risk factors

Surgery for Obesity and Related Diseases ◽

10.1016/j.soard.2008.03.131 ◽

2008 ◽

Vol 4 (3) ◽

pp. 339

Author(s):

Gavitt Woodard ◽

John Downey ◽

Joseph Peraza ◽

John Morton

Keyword(s):

Risk Factors ◽

Gastric Bypass ◽

Cardiac Risk ◽

Cardiac Risk Factors

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Obesity-related cardiovascular risk factors after weight loss: a clinical trial comparing gastric bypass surgery and intensive lifestyle intervention

Acta Endocrinologica ◽

10.1530/eje-10-0514 ◽

2010 ◽

Vol 163 (5) ◽

pp. 735-745 ◽

Cited By ~ 122

Author(s):

D Hofsø ◽

N Nordstrand ◽

L K Johnson ◽

T I Karlsen ◽

H Hager ◽

...

Keyword(s):

Risk Factors ◽

Type 2 Diabetes ◽

Gastric Bypass ◽

Cardiovascular Risk ◽

Cardiovascular Risk Factors ◽

Lifestyle Intervention ◽

Bypass Surgery ◽

Gastric Bypass Surgery ◽

Surgery Group

ObjectiveWeight reduction improves several obesity-related health conditions. We aimed to compare the effect of bariatric surgery and comprehensive lifestyle intervention on type 2 diabetes and obesity-related cardiovascular risk factors.DesignOne-year controlled clinical trial (ClinicalTrials.gov identifier NCT00273104).MethodsMorbidly obese subjects (19–66 years, mean (s.d.) body mass index 45.1 kg/m2(5.6), 103 women) were treated with either Roux-en-Y gastric bypass surgery (n=80) or intensive lifestyle intervention at a rehabilitation centre (n=66). The dropout rate within both groups was 5%.ResultsAmong the 76 completers in the surgery group and the 63 completers in the lifestyle group, mean (s.d.) 1-year weight loss was 30% (8) and 8% (9) respectively. Beneficial effects on glucose metabolism, blood pressure, lipids and low-grade inflammation were observed in both groups. Remission rates of type 2 diabetes and hypertension were significantly higher in the surgery group than the lifestyle intervention group; 70 vs 33%,P=0.027, and 49 vs 23%,P=0.016. The improvements in glycaemic control and blood pressure were mediated by weight reduction. The surgery group experienced a significantly greater reduction in the prevalence of metabolic syndrome, albuminuria and electrocardiographic left ventricular hypertrophy than the lifestyle group. Gastrointestinal symptoms and symptomatic postprandial hypoglycaemia developed more frequently after gastric bypass surgery than after lifestyle intervention. There were no deaths.ConclusionsType 2 diabetes and obesity-related cardiovascular risk factors were improved after both treatment strategies. However, the improvements were greatest in those patients treated with gastric bypass surgery.

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