Obesity surgery · 2025
Comparative Risk of Gallstone Formation After Sleeve Gastrectomy and Roux-En-Y Gastric Bypass: A Systematic Review and Meta-Analysis.
Сравнительное исследованиеСтатьяМетаанализСистематический обзорНазвание и аннотация: Перевод пока не подготовлен
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Silva-Chavez Wilson, Bustamante-Cabrejo Alexander, Caballero-Alvarado Jose, Lau-Torres Victor, Sarmiento-Falen Joaquin, Zavaleta-Corvera Carlos
Аннотация
OBJECTIVE: To compare the risk of gallstone formation after sleeve gastrectomy (SG) versus Roux-en-Y gastric bypass (RYGB).
METHODS: We searched PubMed, Scopus, Web of Science, and Embase following PRISMA 2020. Eligible observational studies reported incident cholelithiasis after SG or RYGB. Risk of bias was assessed with the Newcastle-Ottawa Scale (NOS). Pooled odds ratios (ORs) with 95% confidence intervals (CIs) were estimated using random-effects (DerSimonian-Laird). Prespecified subgroup analyses considered follow-up duration (< 2 vs. ≥ 2 years).
RESULTS: Ten studies (n = 195,665) met inclusion criteria. Overall, SG was associated with a lower risk of gallstone formation than RYGB (OR 0.68, 95% CI 0.53-0.88; p = 0.003; I²=75%). The protective association was evident in studies with < 2 years of follow-up (OR 0.59, 95% CI 0.42-0.82; I²=46%) but not in ≥ 2-year follow-up (OR 0.84, 95% CI 0.55-1.28; I²=70%). In influence analysis excluding the largest database study, the summary effect became statistically non-significant with extreme heterogeneity (OR 0.31, 95% CI 0.03-2.72; I²=99%). Methodological quality was moderate to high (NOS 6-8/9).
CONCLUSIONS: SG is associated with a lower short-term risk of gallstone formation compared with RYGB, although results are heterogeneous and sensitive to study weight. Standardized outcome definitions, longer follow-up, and stratification by UDCA use are needed to refine comparative risk estimates.
METHODS: We searched PubMed, Scopus, Web of Science, and Embase following PRISMA 2020. Eligible observational studies reported incident cholelithiasis after SG or RYGB. Risk of bias was assessed with the Newcastle-Ottawa Scale (NOS). Pooled odds ratios (ORs) with 95% confidence intervals (CIs) were estimated using random-effects (DerSimonian-Laird). Prespecified subgroup analyses considered follow-up duration (< 2 vs. ≥ 2 years).
RESULTS: Ten studies (n = 195,665) met inclusion criteria. Overall, SG was associated with a lower risk of gallstone formation than RYGB (OR 0.68, 95% CI 0.53-0.88; p = 0.003; I²=75%). The protective association was evident in studies with < 2 years of follow-up (OR 0.59, 95% CI 0.42-0.82; I²=46%) but not in ≥ 2-year follow-up (OR 0.84, 95% CI 0.55-1.28; I²=70%). In influence analysis excluding the largest database study, the summary effect became statistically non-significant with extreme heterogeneity (OR 0.31, 95% CI 0.03-2.72; I²=99%). Methodological quality was moderate to high (NOS 6-8/9).
CONCLUSIONS: SG is associated with a lower short-term risk of gallstone formation compared with RYGB, although results are heterogeneous and sensitive to study weight. Standardized outcome definitions, longer follow-up, and stratification by UDCA use are needed to refine comparative risk estimates.