Incidence and predictors of gallstone disease after bariatric surgery in a Thai population

BACKGROUND Several prior studies have reported a high incidence of gallstone disease post-bariatric surgery. However, its incidence and predictive factors in Asian populations have not been adequately studied. AIM To evaluate the incidence and predictive factors of gallstone disease post-bariatric surgery in a Thai population. METHODS We retrospectively evaluated patients who underwent laparoscopic sleeve gastrectomy or laparoscopic Roux-en-Y gastric bypass at a University Hospital in Thailand between July 2012 and December 2019. All patients underwent annual imaging studies for gallstones both before and after surgery. The predictive factors for postoperative gallstone disease were analyzed using univariate and multivariate analyses. RESULTS A total of 243 patients who underwent laparoscopic sleeve gastrectomy (70.8%) or laparoscopic Roux-en-Y gastric bypass (29.2%) were included in the analysis, with a mean age of 36.4 years. The incidence of postoperative gallstone disease was 19.3%, comprising 1.2% symptomatic and 18.1% asymptomatic cases, with a median follow-up of 24.6 (range: 6.1-98.4 months). Preoperative body mass index (BMI) was the only factor significantly associated with postoperative gallstone disease (P = 0.004). Patients with a BMI ≥ 50 kg/m2 were three times more likely to develop postoperative gallstone disease post-bariatric surgery compared to those with a BMI < 50 kg/m2 (P = 0.013). CONCLUSION The incidence of gallstone disease after bariatric surgery was relatively high. Preoperative BMI was the only predictive factor in this study. As only a few patients developed symptomatic gallstones post-bariatric surgery, the necessity of routine gallstone screening and prophylactic treatment in this population requires further evaluation.