ABSTRACT
Objective:
To analyze the
incidence of
gallstone formation after
Roux-en-Y gastric bypass (RYGB) and sleeve
gastrectomy (SG) by
meta-analysis.
Methods:
English terms for this
meta-analysis included "
bariatric surgery,
gastric bypass, Roux-n-Y
gastric bypass, RYGB, sleeve
gastrectomy, SG,
cholelithiasis,
cholecystectomy,
gallstone". Researched articles in
Pubmed,
Medline and Embase databases were searched up to February 2023 and retrieved for further
analysis. The quality of each article was evaluated with Newcastle-Ottawa Scale (NOS). Generated data were analyzed with Revman 5.4.
Results:
Nine relevant
cohort studies were retrieved for this
meta-analysis, including a total of 24 255 RYGB
patients and 4 500 SG
patients. All articles met the requirements after the quality evaluation of NOS. The
meta-analysis results showed that the
incidence of postoperative
gallstones in RYGB group was higher than that in SG group ( P<0.001). In subgroup
analysis, by administering
ursodeoxycholic acid (UDCA) for
gallstone prevention, the
incidence had no difference between the two groups ( P=0.090), while in the study without UDCA, the
incidence of
gallstones after RYGB was higher than SG ( P=0.005). In the studies with follow-up
time no more than 24 months, the
incidence of postoperative
gallstones in RYGB group was higher than that in SG group ( P=0.050), but there was no statistical difference when following-up beyond 24 months ( P=0.240).
Conclusions:
Within 2 years after
surgery, RYGB
patients have more chances to develop
gallstones than SG
patients. However, beyond 2-year follow-up, there is no difference between the two
procedures. Prophylactical utilization of UDCA after RYGB can effectively reduce the
incidence of
gallstone formation.