Incidence of Cholecystitis in Patients Undergoing Different Types of Bariatric Surgery: A Systematic Review
DOI:
https://doi.org/10.36489/saudecoletiva.2025v15i97p16230-16247Keywords:
Bariatric Surgery, Cholecystitis, Cholelithiasis, Postoperative ComplicationsAbstract
Objective: To evaluate the incidence of cholecystitis in patients undergoing different bariatric surgery techniques,
identifying risk factors and preventive strategies. Method: Systematic review of the literature in PubMed, SciELO,
BVS, ScienceDirect, and Cochrane Library using DeCS and MeSH descriptors “Bariatric Surgery”, “Cholecystitis”,
and “Postoperative Complications”. Selection of studies published in the last ten years reporting quantitative data
on postoperative cholecystitis. Screening in three phases according to PRISMA guidelines. Results: Seven studies associated vertical gastrectomy with higher rates of cholecystitis, especially in the first postoperative year. Prophylactic interventions with ursodeoxycholic acid significantly reduced gallstone formation. Factors such as rapid weight loss and female sex increased risk. Conclusion: Cholecystitis incidence varies by bariatric technique and
individual factors. Pharmacological prophylaxis and individualized monitoring may optimize clinical outcomes.
References
Svarts A, Thorell A, Engwall M. Volume creates value: The volume–outcome relationship in Scandinavian obesity surgery. Health Serv Manage Res. 2022;35(4):229–39.
Alsallamin I, Chakhachiro D, Bawwab A, Nassar M, Alsallamin A. Prevalence of symptomatic gallbladder disease after bariatric surgery: a literature review. Cureus. 2023;15(4).
Marciniak C, Lenne X, Bruandet A, Hamroun A, Géinin M, Baud G, et al. Risk-benefit balance of simultaneous gastric bypass or sleeve gastrectomy and concomitant cholecystectomy: a comprehensive nationwide cohort of 289,627 patients. Ann Surg. 2023;278(5):725–31.
Gao Z, Liang Y, Huang S, Wu Z, Li M, Yang J. Prevalence and associated factors of vitamin D deficiency after Roux-en-Y gastric bypass: a systematic review and meta-analysis. Int J Surg. 2023;109(12):4273–85.
Gulinac M, Miteva DG, Peshevska-Sekulovska M, Novakov IP, Antovic S, Peruhova M, et al. Long-term effectiveness, outcomes and complications of bariatric surgery. World J Clin Cases. 2023;11(19):4504.
Della Penna A, Lange J, Hilbert J, Archid R, Königsrainer A, Quante M. Ursodeoxycholic acid for 6 months after bariatric surgery is impacting gallstone associated morbidity in patients with preoperative asymptomatic gallstones. Obes Surg. 2019;29:1216–21.
Jawaid M, El-Sherif T, George A, Bonatti HJ. Acute cholecystitis in a gastric bypass patient complicated by Takotsubo cardiomyopathy. Case Rep Surg. 2022;2022(1):5416092.
Bandr A, Alshammari F, Almakinzy H, Alshehri M. Prevalence of cholecystitis in morbidly obese patients after laparoscopic sleeve gastrectomy. Br J Surg Sci. 2021;1(1).
Zeb M, Zarin M, Khan IA, et al. Scope of laparoscopic cholecystectomy in patient with history of previous upper abdominal surgery. Pak J Med Health Sci. 2023;17(2):518.
Salman MA, Salman A, Mohamed US, Hussein AM, Ameen MA, Omar HSE, et al. Ursodeoxycholic acid for the prevention of gallstones after laparoscopic sleeve gastrectomy: a prospective controlled study. Surg Endosc. 2022;36(9):6396–402.
De Lucena AVS, Cordeiro GG, Leão LHA, Kreimer F, De Siqueira LT, Da Conti Oliveira Sousa G, et al. Cholecystectomy concomitant with bariatric surgery: safety and metabolic effects. Obes Surg. 2022;32(4):1093–102.
Okoli C, Schabram K. A guide to conducting a systematic literature review of information systems research [Internet]. SSRN Electron J. 2015. Available from: https://doi.org/10.2139/ssrn.1954824
Donato H, Donato M. Etapas na condução de uma revisão sistemática. Acta Med Port. 2019;32(3):227–35.
Page MJ, McKenzie JE, Bossuyt PM, Boutron I, Hoffmann TC, Mulrow CD, et al. A declaração PRISMA 2020: diretriz atualizada para relatar revisões sistemáticas. Rev Panam Salud Publica. 2023;46:e112.
Jadad AR. Randomised controlled trials: a user’s guide. Health Technol Assess. 1998;2(13):214.
Sterne JAC, Hernán MA, Reeves BC, Savović J, Berkman ND, Viswanathan M, et al. ROBINS-I: a tool for assessing risk of bias in non-randomised studies of interventions. BMJ. 2016;355:i4919.
Habeeb TAAM, Kermansaravi M, Giménez ME, Manangi MN, Elghadban H, Abdelsalam SA, et al. Sleeve gastrectomy and cholecystectomy are safe in obese patients with asymptomatic cholelithiasis: a multicenter randomized trial. World J Surg. 2022;46(7):1721–33.
Ribeiro Jr MA, Tebar GK, Niero HB, Pacheco LS. Biliary complications associated with weight loss, cholelithiasis and choledocholithiasis. World J Gastrointest Pharmacol Ther. 2024;15(4):95647.
Talha A, Farouk A, Hasouna I. Cholelithiasis after weight loss surgery: challenge and prophylaxis. Ain Shams J Surg. 2016;9(2):267–74.
Talha A, Abdelbaki TN, Farouk AM, Hasouna E, Azzam EZ, Shehata G. Cholelithiasis after bariatric surgery, incidence, and prophylaxis: randomized controlled trial. Surg Endosc. 2019;34:5331–7.
Hernández LA, Guilbert L, Sepúlveda EM, Rodríguez F, Peñuñuri F, García VH, et al. Causes of revisional surgery, reoperations, and readmissions after bariatric surgery. Rev Gastroenterol Mex (Engl Ed). 2023;88(3):232–7.
Anveden Å, Peltonen M, Näslund I, Torgerson J, Carlsson LMS. Long-term incidence of gallstone disease after bariatric surgery: results from the nonrandomized controlled Swedish Obese Subjects study. Surg Obes Relat Dis. 2020;16(10):1474–82.
Dai Y, Luo B, Li W. Incidence and risk factors for cholelithiasis after bariatric surgery: a systematic review and meta-analysis. Lipids Health Dis. 2023;22(1):5.
Guzmán HM, Sepúlveda M, Rosso N, San Martin A, Guzmán F, Guzmán HC. Incidence and risk factors for cholelithiasis after bariatric surgery. Obes Surg. 2019;29:2110–4.
Andrés-Imaz A, Martí-Gelonch L, Eizaguirre-Letamendia E, Asensio-Gallego JI, Enríquez-Navascués JM. Incidencia y factores de riesgo para el desarrollo de colelitiasis tras cirugía bariátrica. Cir Esp. 2021;99(9):648–54.
Mohammed A. Reduction of cholelithiasis after bariatric surgery. Med J Cairo Univ. 2020;88(March):427–32.
Sakran N, Dar R, Assalia A, Neeman Z, Farraj M, Sherf-Dagan S, et al. The use of Ursolit for gallstone prophylaxis following bariatric surgery: a randomized-controlled trial. Updates Surg. 2020;72:1125–33.
Haal S, Guman MSS, Bruin S, Schouten R, van Veen RN, Fockens P, et al. Risk factors for symptomatic gallstone disease and gallstone formation after bariatric surgery. Obes Surg. 2022;32(4):1270–8.
Allatif REA, Mannaerts GHH, Al Afari HST, Hammo AN, Al Blooshi MS, Bekdache OA, et al. Concomitant cholecystectomy for asymptomatic gallstones in bariatric surgery—safety profile and feasibility in a large tertiary referral bariatric center. Obes Surg. 2022;1–7.
