Department of Gastroenterological Surgery/Clinical Research Institute, National Kyushu Medical Center, 1-8-1 Jigyohama, Chuo-ku, Fukuoka, 810-8563, Japan.
Department of Surgery, Hiroshima Red Cross Hospital & Atomic-Bomb Survivors Hospital, 1-9-6 Senda-machi, Naka-ku, Hiroshima, 730-8619, Japan.
Obes Surg. 2022 Oct;32(10):3404-3409. doi: 10.1007/s11695-022-06253-z. Epub 2022 Aug 25.
Patients who have undergone bariatric surgery are at risk for gallstone formation. However, the incidence of gallstone formation after bariatric surgery has not been adequately studied in the Japanese population. We aimed to elucidate the incidence and risk factors for gallstone formation after laparoscopic sleeve gastrectomy (LSG) for Japanese patients with severe obesity.
We conducted a retrospective cohort study among patients with severe obesity treated with LSG between April 2017 and June 2020 at two institutions. Patients who had received previous cholecystectomy, had preoperative gallstones, and had received postoperative prophylactic ursodeoxycholic acid were excluded. Body weight, body mass index, and blood data were collected at each follow-up visit before and after the surgery. Follow-up abdominal ultrasonography was performed 6-12 months after surgery, and the incidence of gallstones was calculated. The association between the data and gallstone formation was evaluated.
During the study period, we performed LSG for 98 patients. Of these, 61 cases remained by above conditions and were examined using abdominal ultrasonography over 6 months after surgery. The incidence of gallstones was 23.0% and that of symptomatic gallstones was 3.3%. Anti-Helicobacter pylori antibody seropositive and titer were the only factors that showed significant association with de novo gallstone formation after LSG.
Anti-Helicobacter pylori antibody seropositive may be associated with de novo gallstone formation after LSG for Japanese patients with severe obesity.
接受减重手术的患者有发生胆结石形成的风险。然而,在日本人群中,减重手术后胆结石形成的发生率尚未得到充分研究。我们旨在阐明腹腔镜袖状胃切除术(LSG)治疗日本严重肥胖患者后胆结石形成的发生率和危险因素。
我们对两家机构在 2017 年 4 月至 2020 年 6 月期间接受 LSG 治疗的严重肥胖患者进行了回顾性队列研究。排除了既往接受过胆囊切除术、术前有胆囊结石和术后接受预防性熊去氧胆酸治疗的患者。收集了手术前后每次随访时的体重、体重指数和血液数据。术后 6-12 个月进行随访腹部超声检查,计算胆结石的发生率。评估数据与胆结石形成之间的关联。
在研究期间,我们为 98 例患者进行了 LSG。其中,61 例符合上述条件,在术后 6 个月以上接受了腹部超声检查。胆结石的发生率为 23.0%,有症状的胆结石发生率为 3.3%。抗幽门螺杆菌抗体阳性和滴度是与 LSG 后新发胆结石形成唯一有显著关联的因素。
抗幽门螺杆菌抗体阳性可能与日本严重肥胖患者接受 LSG 后新发胆结石形成有关。