From the Research
Approximately 4.5% of patients experience recurrent gallbladder symptoms after bariatric surgery, as reported in the most recent study 1. This recurrence rate varies depending on the type of bariatric procedure performed, with higher rates typically seen after rapid weight loss procedures like gastric bypass or sleeve gastrectomy. Some key factors that contribute to the development of gallbladder symptoms after bariatric surgery include:
- Rapid weight loss, which increases cholesterol saturation in bile and promotes gallstone formation
- Changes in gallbladder motility
- Altered hormone levels affecting bile composition
- Pre-existing asymptomatic gallstones, which are more likely to become symptomatic after surgery To reduce this risk, some surgeons recommend prophylactic cholecystectomy during bariatric surgery for patients with existing gallstones, while others prescribe ursodeoxycholic acid (typically 300-600 mg daily) for the first 6 months after surgery to prevent gallstone formation 2, 3, 4. Patients should be monitored for symptoms like right upper quadrant pain, nausea after eating fatty foods, and referred promptly for ultrasound if symptoms develop. It's also important to note that the incidence of gallstone formation after bariatric surgery can be as high as 10-38% and is often associated with a proportional increase in the risk of developing biliary complications 4. However, the most recent and highest quality study suggests that the prevalence of gallbladder disease after bariatric surgery is low and comparable to the general population without bariatric surgery 1. Therefore, routine postoperative administration of ursodeoxycholic acid (UDCA) may be recommended to prevent gallstone formation, especially during the period of rapid weight loss (first 3-6 months postoperatively) 4.