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Cholecystectomy more frequent with higher BMI, triglycerides in obese cohort
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Elevated BMI and serum triglyceride levels increased the risk for required cholecystectomy among obese patients undergoing rapid medical weight loss, according to results presented at the Society of American Gastrointestinal and Endoscopic Surgeons Annual Meeting in Baltimore.
Researchers evaluated data from 2,851 obese participants enrolled in a medically supervised rapid weight loss program at the Weight Management Clinic at The Ottawa Hospital between 1992 and 2008. No participants had undergone cholecystectomy before initiation of the program.
Cholecystectomy was performed in 9% of the cohort. Multivariate analysis indicated that menstruating females and patients using hormone-replacement therapy or oral contraceptives were significantly more likely to undergo the procedure.
Weight loss of more than 1.5 kg/week and triglyceride levels above 1.7 mmol/L also were independently predictive of cholecystectomy, along with incremental BMI increases of 5. Investigators noted associations between reduced risk for cholecystectomy and lipid-lowering medications and total bilirubin levels above 17 mcmol/L (P≤.05 for all). Serum total cholesterol levels >5.2 mmol/L, sex and history of pregnancy did not impact cholecystectomy risk.
“Multiple patient factors were found to be associated with an increased risk of requiring cholecystectomy in individuals undergoing rapid medical weight loss,” the researchers wrote. “Future studies should determine if these factors could be predictive of who will develop symptomatic cholelithiasis and require cholecystectomy in the bariatric surgery population. This knowledge would be helpful to guide decision-making for surgeons who are considering when to offer concomitant cholecystectomy at the time of bariatric surgery.”
For more information:
Berg A. S009: Predictive Factors for Cholecystectomy in Bariatric Patients Undergoing Medically Supervised Weight Loss. Presented at: the Society of American Gastrointestinal and Endoscopic Surgeons 2013 Annual Meeting; April 17-20, Baltimore.