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Obesity Surgery

, Volume 19, Issue 1, pp 22–28 | Cite as

Early Changes in Postprandial Gallbladder Emptying in Morbidly Obese Patients Undergoing Roux-en-Y Gastric Bypass: Correlation with the Occurrence of Biliary Sludge and Gallstones

  • Michel BastoulyEmail author
  • Carlos Haruo Arasaki
  • Jael Brasil Ferreira
  • Arnaldo Zanoto
  • Fabíola Gouveia H. P. Borges
  • José Carlos Del Grande
Research Article

Abstract

Background

Gallstones have been frequently diagnosed after Roux-en-Y gastric bypass (RYGBP). Gallbladder stasis associated with duodenal exclusion may play a role in their pathogenesis.

Methods

Gallbladder emptying was studied before and on the 30th and 31st postoperative days (POD) after RYGBP in 20 morbidly obese patients. Gallbladder volume after fasting and every 15 min during a 2-h period following administration of a standard liquid meal was determined by sonography. On the 31st POD, the meal was administered through the gastrostomy in order to promote its transit through the duodenum. Fasting volume (FV), maximum ejection fraction (Max EF), and residual volume (RV) were determined. Biliary sludge and calculi were investigated after 1 and 6 months, respectively.

Results

FV was 39.4 ± 20.2 ml, 50.1 ± 22.7 ml, and 47.9 ± 23.4 ml, respectively, for the preoperative and two postoperative assessments (P = 0.09). RV was 7.6 ± 8.7 ml, 25.1 ± 20.0 ml, and 24.6 ± 20.9 ml; and Max EF was 80.5 ± 20.9%, 54.3 ± 21.4%, and 50.5 ± 29.0%, respectively, for the pre-, postoral, and postgastrostomy infusion measurements. There was only a significant difference between the preoperative value and the two postoperative values (P < 0.001). Biliary sludge was detected in 65% of the patients and 46% of them subsequently developed gallstones.

Conclusions

Gallbladder emptying became significantly compromised after RYGBP. This impairment was unrelated to duodenal exclusion but it was associated with biliary sludge and stone formation.

Keywords

Morbid obesity Cholelithiasis Gallbladder emptying Gastroplasty Ultrasonography Bariatric surgery 

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Copyright information

© Springer Science + Business Media, LLC 2008

Authors and Affiliations

  • Michel Bastouly
    • 1
    • 5
    Email author
  • Carlos Haruo Arasaki
    • 1
  • Jael Brasil Ferreira
    • 2
  • Arnaldo Zanoto
    • 3
  • Fabíola Gouveia H. P. Borges
    • 2
  • José Carlos Del Grande
    • 4
  1. 1.Department of SurgeryFederal University of São PauloSão PauloBrazil
  2. 2.Hospital Santa Casa de SantosSão PauloBrazil
  3. 3.University of São PauloSão PauloBrazil
  4. 4.Division of the Esophagus, Stomach and Small Bowel, Department of SurgeryFederal University of São PauloSão PauloBrazil
  5. 5.SantosBrazil

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