| Objective:Laparoscopic sleeve gastrectomy(LSG)is widely recognized in Bariatric surgery and is one of the most popular Bariatric surgery.At present,there is limited data on the incidence of gallbladder stones after laparoscopic gastrectomy and this study aims to determine the incidence of gallstones after laparoscopic gastrectomy(LSG)and to explore the risk of gallstones after Bariatric surgery.Methods:A retrospective study of 161 patients who underwent laparoscopic sleeve gastrectomy(LSG)in minimally invasive surgery at the People’s Hospital of Autonomous Region from October 2017 to September 2019.Of these,13 patients had a history of cholecystectomy,and 21 patients were found to have gallstones before surgery and had simultaneous cholecystectomy.The remaining 127 patients collected preoperative general data and laboratory examination data,and were followed up in hospital,outpatient,and telephone 12 months after surgery.According to the postoperative B-ultrasound results: 104 patients had no new gallstones or cholestasis after operation,and they were set as group A(normal group);23 patients had new cholecystolithiasis or cholestasis after operation,which was set as B Group(cholecystolithiasis group),comparative analysis of body weight,abdominal circumference,body mass index(BMI),extra weight loss rate(EWL%),fasting blood glucose(FPG),glycosylated hemoglobin(HbA1c)),Steady-state insulin evaluation index(HOMA-IR),total cholesterol(TC),triglyceride(TG),high-density lipoprotein cholesterol(HDL-C),low-density lipoprotein cholesterol(LDL-C)and other indicators.Results: A total of 127 patients were included in this study.All operations were successfully completed under laparoscopy,and there was no conversion to open surgery.Twelve months after surgery,23(18.1%)cases found new gallstones or cholestasis.Comparison of the data between the two groups and general data before the operation between the two groups.The study found that according to the age distribution of patients in groups A and B,the gallbladder The age of the stone group was higher than that of the non-cholecystolithiasis group(p <0.05).There was no significant difference in gender distributionbetween group A and group B,and no statistical significance(p> 0.05).There was no significant difference in preoperative BMI between group A and group B,and no statistical significance(p> 0.05).There was no significant difference between group A and group B in comorbidities such as type 2diabetes,hypertension,gastroesophageal reflux disease(GERD)and obstructive sleep apnea syndrome(OSAS),and no statistical significance(p> 0.05).12 months postoperative weight,abdominal circumference,body mass index(BMI),fasting blood glucose(FPG),steady-state insulin evaluation index(HOMA-IR),triglyceride(TG),high-density lipoprotein cholesterol(HDL)-C),low-density lipoprotein cholesterol(LDL-C)change trend comparison,the difference was not statistically significant(P> 0.05);12 months after operation of the two groups of patients EWL,total cholesterol change trend comparison,the difference All have statistical significance(P <0.05).Multivariate regression analysis showed that the age of preoperative patients ≥ 40 years old and the preoperative BMI ≥ 40 were independent risk factors leading to postoperative gallstones(P <0.05).Conclusions:In this study,the incidence of gallstones and gallbladder stones after LSG was 18.1%,which was significantly higher than that of the general population.The rapid weight loss after LSG is significantly related to the incidence of gallstones.In addition,we believe that preoperative age ≥ 40 and preoperative BMI ≥ 40 kg / m2 are independent risk factors for gallstone formation after LSG.The increase of total cholesterol in patients with gallbladder stones after LSG may be one of the conditions for gallstone formation.At present,there are no clear risk factors for gallstone formation after LSG,and a prospective randomized controlled study is needed. |
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