Biliary Considerations Before, During, and After Metabolic Surgery

Bariatric surgery and benign biliary disease, including symptomatic cholelithiasis and cholecystitis, requiring surgical intervention have both steadily increased over the last several years. Furthermore, it is known that both patients with obesity and those patients undergoing rapid weight loss following bariatric surgery are at increased risk for gallstone formation and the above pathologies. Despite this, there remain few guidelines for the screening and management of biliary disease in these patients. In the following chapter we will discuss screening in asymptomatic patients, technical concerns to consider in these patients following bariatric surgery, as well as medical management with ursodeoxycholic acid during the period of rapid weight loss.