Gallbladder Problems After Weight Loss Surgery

Gallstone - Bariatric SurgeryGallbladder symptoms are extremely common in obese and overweight individuals. These problems within the gallbladder are called Gallstones, which are caused primarily by:

  1. High cholesterol levels
  2. High fatty deposit levels
  3. Larger gallbladders
  4. Larger abdominal girth

The liver creates bile, which helps the digestion of fatty acids. Unfortunately, if cholesterol gets too high, bile is unable to process correctly which causes a blockage creating gallbladder problems known as gallstones.

Bariatric surgery, or weight loss surgery, is a procedure that makes it possible to eliminate excess weight by making modifications to your digestive tract. Rapid weight loss (3 to 5 lbs per week) can cause gallbladder disease in post-bariatric patients.

Why Do Gallstones Form?

The gallbladder is a key component of the digestive tract. The gallbladder stores bile which is produced by the liver. Bile helps with the digestion of fatty acids. Removing the gallbladder does not halt the liver from creating the bile required to digest fats. Rather than being stored in the gut, the bile will trickle to your digestive tract, forming gallstones.

Gallstones in the Gallbladder - Gallstones and Bariatric Surgery

In case of abdominal pain complaints, the following tests are performed to diagnosis the presence of gallbladder disease.

  1. Ultrasound
  2. Hida Scan (Nuclear Medicine)

Gallstones Forming Post Bariatric Operation

Gallstones are common and affect at least 1/4 of obese individuals. This is because of the extremely high cholesterol and fat levels. In many cases, gallstones become so bad that they need to be surgically removed.

After weight loss surgery, gallstones form because of rapid weight loss generated from bariatric procedures like laparoscopic gastric bypass or gastric sleeve surgery.

Bariatric surgery is so effective because it changes or at least disrupts the digestion process so that food is not broken down and absorbed as originally intended. A decline in the number of calories and nutrients consumed enables individuals to shed weight and lessen their risk of obesity-related health dangers or disorders.

This fat loss and rapid weight loss are risk factors for developing gallstones. There is also a heightened risk for gallstones in case you have a diet high in processed carbohydrates, calories, and fiber.

How to Know if You Have Gallstones - Signs, Symptoms, and Treatment

Gallbladder Incidence After Gastric Bypass Surgery

The primary potential mechanism is the low cholecystokinin secretion because of reduced neighborhood enteric-endocrine reflex leading to duodenal exclusion. Prophylactic cholecystectomy through the Roux-en-Y gastric bypass surgery was indicated to decrease the prevalence of gallstone-related complications.

The risk of gallstone formation following gastric bypass surgery is as large as 50% within the first year after the operation.

Gallstones After Gastric Bypass Surgery

Gastric bypass uses a malabsorptive component, which gives bypass a greater chance of gallstones occurring. Purely restrictive processes like sleeve gastrectomy can lead to less gallstone formation since complete gastrointestinal movement, and entero-endocrine reflex has been preserved. To our knowledge, no reports from the literature have examined the prevalence of gallstone formation comparing gastric sleeve surgery to gastric bypass surgery.

Gallbladder Incidence After Gastric Sleeve

According to the other research, a greater prevalence of gallstones has been reported in gastric sleeve surgery patients compared to the overall obese population.

Cholelithiasis, or gallstones, occurred in 30% of patients receiving gastric sleeve surgery.

However, the present theories posit the operative dissection of the vagal back influences rectal contractility and a non-physiological reshaping of their gastrointestinal tract; for example, duodenal exception contributes to enhanced gallstone formation. The current study assessed the prevalence of gallstone formation following gastrectomy for stomach cancer and identified it as a risk factor for gallstones.

Gallstones After Gastric Sleeve

In gastric sleeve surgical procedures, the surgeon removes almost 80 to 85 percent of your stomach, leaving just an elongated-shaped sac that is closed with staples. This kind of bariatric process is also known as Vertical Sleeve Gastrectomy (VSG). Unlike sleeve gastrectomy, other bariatric surgeries additionally alter your gut, the principal organ of the body absorbs nutrients and calories from foods and drinks.

The primary purpose of gastric sleeve surgery is to decrease the capacity of the stomach, which makes you feel full sooner. Taking out a part of your stomach may also impact hormones and gut bacteria that might influence metabolism and appetite. This sort of surgical procedure cannot be reversed once the surgical procedure is performed because the gastric sleeve surgical procedure permanently removes the majority of the stomach.

The prevalence of gallstone formation after gastric sleeve surgery was found in 21.4 percent of sleeve patients. Total gastrectomy, Billroth II reconstruction along diabetes mellitus were risk factors for gallstone formation. Total gastrectomy can be a risk factor for complex gallstones.

Lap Band Gallbladder Issues

Lap Band, or gastric banding, has a reduced chance of gallbladder issues or gallstones compared to more aggressive weight loss procedures. This is primarily due to the less efficacy of the procedure because it causes less weight loss at a much slower pace in comparison with gastric sleeve or bypass.

Gallbladder Removal / Surgery and Weight Loss

The gallbladder may be removed via an abdominal incision. Nowadays, it is more probable your physician will choose the laparoscopic surgical procedure. This process involves a couple of tiny incisions. Your hospital stay and complete recovery period will probably be substantially shorter following a laparoscopic operation.

How to Prevent Gallstones After Weight Loss Surgery

The increased efficiency from weight loss surgery (like gastric bypass, gastric sleeve, or duodenal switch) appears to be the impact that the surgery has on gastric hormones which affect numerous factors such as appetite, satiety, and blood glucose management.

Can Gallstones Cause Weight Gain

Obesity is one of the most common causes of gallstones – not the other way around. Gallstones do not generally cause weight gain. They are primarily caused by being overweight or losing weight rapidly.

Some bariatric surgeons offer gallbladder removal (Cholecystectomy) during your weight loss surgery procedure if there is any indication of gallbladder disease. Gallbladders are usually only removed if they are damaged or high-risk for gallstones or problems later on. It is a common practice to do perform concurrent Cholecystectomy-Gallbladder removal with a Duodenal Switch (DS) procedure.

Consult with your bariatric doctor near you if you think you may have gallstones.