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Aims <p>To evaluate the impact of type 2 diabetes mellitus on symptomatic gallstone development post-bariatric surgery at a tertiary care center in Saudi Arabia, alongside excess weight loss and ursodeoxycholic acid (UDCA) therapy compliance.</p> Materials and methods <p>This retrospective cohort study analyzed 354 patients undergoing sleeve gastrectomy (SG) (n = 303) or Roux-en-Y gastric bypass (RYGB) (n = 51) between 2012 and 2022 at King Abdulaziz University Hospital, Jeddah. Preoperative ultrasonographic screening detected gallstones; patients with gallstones underwent concurrent cholecystectomy, while others received UDCA (300 mg twice daily for 6 months).&#xa0;Symptomatic gallstones were confirmed by ultrasound using standard surgical criteria (episodic right upper quadrant or epigastric pain lasting more than 30 min, with or without nausea or vomiting)&#xa0;during follow-up (minimum 1 year; average 2.7 years). Data included type 2 diabetes mellitus status, duration, HbA1c, medications, percentage excess weight loss (%EWL), and UDCA compliance.</p> Results <p>Symptomatic gallstones developed in 13.6% of patients (48/354; 95% CI: 10.1%–17.8%)—12.5% in SG (38/303) and 21.6% in RYGB (11/51). Type 2 diabetes mellitus significantly increased gallstone risk (multivariate OR = 2.3, 95% CI: 1.1–4.8, P = 0.028), particularly in RYGB. Higher %EWL was associated with gallstones, while UDCA compliance was low (22% in gallstone patients).</p> Conclusions <p>Preoperative type 2 diabetes mellitus is a significant risk factor for gallstone formation after bariatric surgery, particularly in those undergoing RYGB. Targeted prophylactic measures are needed for Saudi patients with type 2 diabetes mellitus.</p>

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Preoperative Diabetes Mellitus Increases Gallstone Formation Risk after Bariatric Surgery: A Retrospective Cohort Analysis

  • 期刊论文

  • 发表日期：

    2026年3月18日

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  • Moaz Abulfaraj,
  • Wisam Jamal

摘要

Aims

To evaluate the impact of type 2 diabetes mellitus on symptomatic gallstone development post-bariatric surgery at a tertiary care center in Saudi Arabia, alongside excess weight loss and ursodeoxycholic acid (UDCA) therapy compliance.

Materials and methods

This retrospective cohort study analyzed 354 patients undergoing sleeve gastrectomy (SG) (n = 303) or Roux-en-Y gastric bypass (RYGB) (n = 51) between 2012 and 2022 at King Abdulaziz University Hospital, Jeddah. Preoperative ultrasonographic screening detected gallstones; patients with gallstones underwent concurrent cholecystectomy, while others received UDCA (300 mg twice daily for 6 months). Symptomatic gallstones were confirmed by ultrasound using standard surgical criteria (episodic right upper quadrant or epigastric pain lasting more than 30 min, with or without nausea or vomiting) during follow-up (minimum 1 year; average 2.7 years). Data included type 2 diabetes mellitus status, duration, HbA1c, medications, percentage excess weight loss (%EWL), and UDCA compliance.

Results

Symptomatic gallstones developed in 13.6% of patients (48/354; 95% CI: 10.1%–17.8%)—12.5% in SG (38/303) and 21.6% in RYGB (11/51). Type 2 diabetes mellitus significantly increased gallstone risk (multivariate OR = 2.3, 95% CI: 1.1–4.8, P = 0.028), particularly in RYGB. Higher %EWL was associated with gallstones, while UDCA compliance was low (22% in gallstone patients).

Conclusions

Preoperative type 2 diabetes mellitus is a significant risk factor for gallstone formation after bariatric surgery, particularly in those undergoing RYGB. Targeted prophylactic measures are needed for Saudi patients with type 2 diabetes mellitus.