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Biliary Disease and Bariatric Surgery

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Global Bariatric Surgery

Abstract

It is known that the rapid weight loss is a predisposing factor to develop biliary lithiasis. Compared with the general population, the obese have high levels of serum cholesterol, determining a higher incidence of lithiasis, which is further increased in the patient population undergoing a bariatric procedure. Furthermore, after bariatric surgery, a decrease in the gallbladder motility due to nerve damage, a deficit in phospholipids and contraction-stimulating proteins, and an increase of mucin secretion toward the gallbladder occur, leading to an acceleration of the nucleation process.

Regarding prophylactic surgery (cholecystectomy), the majority of surgeons concur that a watchful waiting should be taken and only perform the bariatric procedure, because the number of patients that will develop symptomatic cholelithiasis is low (around 6–8% of them) and this leads to an elevated number of patients exposed to an unnecessary procedure with potential complications. Laparoscopic cholecystectomy in bariatric patients may be challenging due to suboptimal port placement and difficult body habitus. Furthermore, it is accompanied by potential risks such as lengthening of operative time, increased morbidity, and prolonged hospitalization.

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Author information

Authors and Affiliations

  1. Department of Bariatric Surgery, Centro Cien– Diagnomed, Buenos Aires, Argentina

    Mariano Palermo

  2. Department of Surgery, DAICIM Foundation, Buenos Aires, Argentina

    Pablo Acquafresca

  3. Department of Surgery, Federal University of Pernambuco (UFPE), Recife, PE, Brazil

    Flávio Coelho Ferreira, Cinthia Barbosa de Andrade & Josemberg Campos

Authors
  1. Mariano Palermo
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  2. Pablo Acquafresca
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  3. Flávio Coelho Ferreira
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  4. Cinthia Barbosa de Andrade
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  5. Josemberg Campos
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Editor information

Editors and Affiliations

  1. University of Illinois at Chicago, Chicago, IL, USA

    Rami Lutfi

  2. University of Buenos Aires, Buenos Aires, Argentina

    Mariano Palermo

  3. Saint-Pierre University Hospital, European School of Laparoscopic Surgery, Brussels, Belgium

    Guy-Bernard Cadière

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Palermo, M., Acquafresca, P., Ferreira, F.C., de Andrade, C.B., Campos, J. (2018). Biliary Disease and Bariatric Surgery. In: Lutfi, R., Palermo, M., Cadière, GB. (eds) Global Bariatric Surgery . Springer, Cham. https://doi.org/10.1007/978-3-319-93545-4_38

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  • DOI: https://doi.org/10.1007/978-3-319-93545-4_38

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-93544-7

  • Online ISBN: 978-3-319-93545-4

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