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Abstract

ABSTRACT: BACKGROUND: The risk factors for development of gallstones have been studied extensively in the general population. They are different when it comes to patients who underwent bariatric operations. Obesity and rapid weight loss induced by weight-reducing surgery are well recognized for the development of gallbladder stones. There is no standard policy whether to perform prophylactic cholecystectomy at the time of the bariatric operation or to give postoperative treatment to decrease the risk. OBJECTIVE: The aim of the study is to evaluate the predictors of gallstone formation post-Bariatric surgery and associated risk factors. The implication behind it will help decide how to follow up postoperatively and whom are at increased risk to develop cholelithasis. METHODS: This prospective study was performed on 100 patients who underwent weight-reducing operations at Al-Imamain Al-Kadimiyen Teaching Hospital. They were followed for 12 months postoperatively. Ultrasonography examination was done for those who developed symptoms suggestive of gallstone formation. RESULTS: Twenty percent of them were found to have gallstones. Of the the parameters enrolled in the study (age, gender, type of surgery, preoperative body mass index, percentage of excess body weight loss), only the factor of the percentage of excess weight loss was the most significant of predicting development of gallstone post-bariatric procedures (p value = 0.002). The preoperative BMI, age, gender and type of operation were found were not found to be statistically significant in terms of its relationship with gallstone formation. CONCLUSION : Concomitant cholecystectomy along with the bariatric procedure is not recommended. Surveillance by ultrasonography for those with excess weight loss more than 25% of their original weight is advised for 1 year postoperatively.

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