Incidence of symptomatic cholelithiasis after laparoscopic sleeve gastrectomy and its association with rapid weight loss

Abstract Nonalcoholic fatty liver disease (NAFLD) is increasingly being linked to obesity. Although laparoscopic sleeve gastrectomy (LSG) is effective for weight loss that can ultimately resolve NAFLD, an initial transient deterioration of liver functions could be observed during the first few months post-operatively, after which a subsequent improvement of the liver functions might occur. Rapid weight loss, nutritional deficiencies, and protein malnutrition can all contribute to hepatic dysfunction and can affect the metabolism of medications such as acetaminophen leading to more insult to a compromised liver. We report acute liver failure after LSG associated with protein calorie malnutrition, multiple nutritional deficiencies in addition to concomitant use of therapeutic doses of acetaminophen. Treatment with N-acetylcysteine, and replacement of deficient multivitamins and trace elements resulted in significant improvement in liver functions.

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Short-Term Multi-Organ and Metabolic Benefits of Rapid Weight Loss on Severely Obese Patients after Laparoscopic Sleeve Gastrectomy

Journal of the American College of Surgeons ◽

10.1016/j.jamcollsurg.2018.08.203 ◽

2018 ◽

Vol 227 (4) ◽

pp. e75-e76

Author(s):

David Gutierrez Blanco ◽

David Romero Funes ◽

Mauricio F. Sarmiento-Cobos ◽

Ramarao Ganga ◽

Emanuele Lo Menzo ◽

...

Keyword(s):

Weight Loss ◽

Sleeve Gastrectomy ◽

Laparoscopic Sleeve Gastrectomy ◽

Rapid Weight Loss ◽

Obese Patients ◽

Short Term ◽

Severely Obese

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Prevalence of Cholecystitis in Morbidly Obese Patients After Laparoscopic Sleeve Gastrectomy

British Journal Of Surgical Science ◽

10.54323/bjoss.2021.3 ◽

2021 ◽

Vol 1 (1) ◽

Author(s):

Bandr ALI ◽

Farah Alshammari ◽

Hamad Almakinzy ◽

Mansour Alshehri

Keyword(s):

Bariatric Surgery ◽

Weight Loss ◽

Sleeve Gastrectomy ◽

Laparoscopic Sleeve Gastrectomy ◽

Statistical Significance ◽

Categorical Variables ◽

Morbidly Obese ◽

Rapid Weight Loss ◽

Continuous Variables ◽

Increased Risk

Background Aims: Rapid weight loss after laparoscopic sleeve gastrectomy is associated with an increased risk of cholelithiasis. With 7-15% of patients requiring cholecystectomy after bariatric surgery, there is ongoing debate regarding the potential benefits of performing cholecystectomy with the primary bariatric surgery. The goals of this study were to investigate the frequency and timing of cholecystectomies post LSG and determine the associated risk of choledocholithiasis post LSG in Prince Sultan Military Medical City, Riyadh. Subjects and methods: A retrospective cohort study of 1112 patients undergoing LSG. The inclusion criteria are patients who are age above 18 years old who underwent laparoscopic sleeve gastrectomy (LSG). Statistical analysis: Analysis was performed using IBM’s Statistical Package for the social Sciences (SPSS) version 21.0. Results were expressed in numbers and percentages for categorical variables. Continuous variables were expressed as means and standard deviations. All the comparisons were analyzed using non-parametric methods. The level selected for statistical significance was a probability value <0.05. Results: Our results shows the main cause of having cholecystitis is the significant loss of weight within the first six months Conclusion: A 17.9% incidence of symptomatic cholelithiasis was noted among post-LSG patients over a period of seven years. Rapid weight loss was the only risk factor that contributed to the development of post-LSG gallbladder stone disease.

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Preoperative metabolic status is associated with adiponectin levels attained 6 months after laparoscopic sleeve gastrectomy, independently of the degree of weight loss

Endocrine Abstracts ◽

10.1530/endoabs.32.p763 ◽

2013 ◽

Cited By ~ 1

Author(s):

Anca Sirbu ◽

Sorina Martin ◽

Carmen Barbu ◽

Catalin Copaescu ◽

Suzana Florea ◽

...

Keyword(s):

Weight Loss ◽

Sleeve Gastrectomy ◽

Laparoscopic Sleeve Gastrectomy ◽

Metabolic Status

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Holter-Derived Autonomic Function, Arrhythmias and Carbohydrate Metabolism in Patients with Class III Obesity Treated with Laparoscopic Sleeve Gastrectomy

Journal of Clinical Medicine ◽

10.3390/jcm10102140 ◽

2021 ◽

Vol 10 (10) ◽

pp. 2140

Author(s):

Piotr Bienias ◽

Zuzanna Rymarczyk ◽

Justyna Domienik-Karłowicz ◽

Wojciech Lisik ◽

Piotr Sobieraj ◽

...

Keyword(s):

Insulin Resistance ◽

Heart Rate ◽

Weight Loss ◽

Sleeve Gastrectomy ◽

Laparoscopic Sleeve Gastrectomy ◽

Carbohydrate Metabolism ◽

Autonomic Function ◽

Young Patients ◽

Resistance Index ◽

Class Iii

The effects of weight loss following bariatric surgery on autonomic balance, arrhythmias and insulin resistance are still of interest. We prospectively investigated 50 patients with BMI > 40 kg/m2, aged 36.5 (18–56) years who underwent laparoscopic sleeve gastrectomy. Among other examinations, all subjects had 24-h Holter monitoring with heart rate variability (HRV) and heart rate turbulence (HRT) evaluation. After a median of 15 months, BMI decreased from 43.9 to 29.7 kg/m2, the incidence of hypertension decreased from 54 to 32% (p = 0.04) and any carbohydrate disorders decreased from 24 to 6% (p = 0.02). Fasting insulin concentration and insulin resistance index improved significantly (p < 0.001). Improvements in HRV parameters related to the sympathetic autonomic division were also observed (p < 0.001), while HRT evaluation was not conclusive. The enhancement of autonomic tone indices was correlated with reduction of BMI (SDNN-I r = 0.281 p = 0.04; SDNN r = 0.267 p = 0.05), but not with reduction of waist circumference, and it was also associated with decrease of mean heart rate (OR 0.02, 95%CI 0.0–0.1, p < 0.001). The incidence of arrhythmias was low and similar before and after follow-up. In conclusion, improvement of homeostasis of carbohydrate metabolism and autonomic function is observed in relatively young patients after weight loss due to laparoscopic sleeve gastrectomy.

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