Early Changes in Postprandial Gallbladder Emptying in Morbidly Obese Patients Undergoing Roux-en-Y Gastric Bypass: Correlation with the Occurrence of Biliary Sludge and Gallstones

Early Changes in Postprandial Gallbladder Emptying in Morbidly Obese Patients Undergoing Roux-en-Y Gastric Bypass: Correlation with the Occurrence of Biliary Sludge and Gallstones

Author Bastouly, Michel Autor UNIFESP Google Scholar
Arasaki, Carlos Haruo Autor UNIFESP Google Scholar
Ferreira, Jael Brasil Google Scholar
Zanoto, Arnaldo Google Scholar
Borges, Fabiola Gouveia H. P. Google Scholar
Del Grande, José Carlos Autor UNIFESP Google Scholar
Institution Universidade Federal de São Paulo (UNIFESP)
Hosp Santa Casa Santos
Universidade de São Paulo (USP)
Abstract Gallstones have been frequently diagnosed after Roux-en-Y gastric bypass (RYGBP). Gallbladder stasis associated with duodenal exclusion may play a role in their pathogenesis.Gallbladder emptying was studied before and on the 30th and 31st postoperative days (POD) after RYGBP in 20 morbidly obese patients. Gallbladder volume after fasting and every 15 min during a 2-h period following administration of a standard liquid meal was determined by sonography. On the 31st POD, the meal was administered through the gastrostomy in order to promote its transit through the duodenum. Fasting volume (FV), maximum ejection fraction (Max EF), and residual volume (RV) were determined. Biliary sludge and calculi were investigated after 1 and 6 months, respectively.FV was 39.4 +/- 20.2 ml, 50.1 +/- 22.7 ml, and 47.9 +/- 23.4 ml, respectively, for the preoperative and two postoperative assessments (P = 0.09). RV was 7.6 +/- 8.7 ml, 25.1 +/- 20.0 ml, and 24.6 +/- 20.9 ml; and Max EF was 80.5 +/- 20.9%, 54.3 +/- 21.4%, and 50.5 +/- 29.0%, respectively, for the pre-, postoral, and postgastrostomy infusion measurements. There was only a significant difference between the preoperative value and the two postoperative values (P < 0.001). Biliary sludge was detected in 65% of the patients and 46% of them subsequently developed gallstones.Gallbladder emptying became significantly compromised after RYGBP. This impairment was unrelated to duodenal exclusion but it was associated with biliary sludge and stone formation.
Keywords Morbid obesity
Cholelithiasis
Gallbladder emptying
Gastroplasty
Ultrasonography
Bariatric surgery
Language English
Date 2009-01-01
Published in Obesity Surgery. New York: Springer, v. 19, n. 1, p. 22-28, 2009.
ISSN 0960-8923 (Sherpa/Romeo, impact factor)
Publisher Springer
Extent 22-28
Origin http://dx.doi.org/10.1007/s11695-008-9648-y
Access rights Closed access
Type Article
Web of Science ID WOS:000262281700005
URI http://repositorio.unifesp.br/handle/11600/31158

Show full item record




File

File Size Format View

There are no files associated with this item.

This item appears in the following Collection(s)

Search


Browse

Statistics

My Account