CHOLELITHIASIS IN PATIENTS AFTER BARIATRIC SURGERY: LITERATURE REVIEW
DOI:
https://doi.org/10.66104/k7tssa54Keywords:
obesity; cholelithiasis; bariatric surgeryAbstract
Obesity is characterized by excessive accumulation of body fat capable of impairing health and is classified according to body mass index (BMI) into normal weight (18–24.9 kg/m²), overweight (25–29.9 kg/m²), and grade I to III obesity (≥30 kg/m²). Since 1975, its global prevalence has tripled, affecting more than 1 billion people worldwide. Bariatric surgery is an effective therapeutic alternative for patients refractory to conservative treatments. Non-neoplastic biliary disease, including cholelithiasis, is a frequent complication in the postoperative period following bariatric surgery, resulting from multiple lithogenic mechanisms such as rapid weight loss, increased release of cholesterol and lipids from adipocytes, and reduction of preoperative BMI ≥25%. The aim of this study was to analyze, through a literature review, the relationship between non-neoplastic biliary disease and obesity, emphasizing risk factors, pathophysiological mechanisms, and the indication of concomitant cholecystectomy during bariatric surgery. Twenty articles published from 2003 onwards were selected from PubMed, SciELO, and LILACS databases using the descriptors bariatric, cholelithiasis, and obesity. The incidence of post-bariatric cholelithiasis ranged from 1.4% to 55.5%, with higher risk observed in women, patients with rapid weight loss, multiparity, or use of oral contraceptives. Protective factors include advanced age, statin use, and prophylaxis with ursodeoxycholic acid. Cholelithiasis tends to occur within the first six months after surgery and is more frequent after gastric bypass. Concomitant cholecystectomy is considered safe and is especially indicated for patients with preexisting gallstones.
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