P0019 - Prevalence of Choledocholithiasis Following Sleeve Gastrectomy

Sunday, October 24, 2021

3:30 PM – 7:00 PM PT

Location: Shoreline Exhibit Hall

Presenting Author(s)

MA

Mohammad Abureesh, MD

Staten Island University Hospital
Staten Island, NY, United States

Mohammad Abureesh, MD¹, Rawan Badran, MD¹, Motasem Alkhayyat, MD², Danyal Khan, MD¹, Aqsa Nisar, MD¹, Ahmad Abouyassine, MD¹, Ahmad Elfiky, MD¹, Loai Dahabra, MD¹, Sherif Andrawes, MD¹
¹Staten Island University Hospital, Staten Island, NY; ²Cleveland Clinic Foundation, Cleveland, OH

Introduction: Multiple studies have shown an increased risk of cholelithiasis in patients after Sleeve Gastrectomy (SG). However, limited data is available regarding the prevalence of Choledocholithiasis in this group of patients. Using a large database, we sought to evaluate this potential risk association.

Methods: We reviewed data extracted from electronic health records of patients > 20 years, provided by a commercial database (Explorys Inc, Cleveland, OH) of 26 major integrated US healthcare systems. We identified a cohort of patients with a diagnosis of SG without "Calculus in biliary tract" from 2016-2021, which served as a control group. Similarly, we identified a cohort of patients with SNOMED-CT diagnosis of "Calculus in biliary tract" after SG diagnosis. Multivariate analysis was performed to adjust for age, gender, race, as well as to evaluate underlying risk factors.

Results: Of the 35,089,510 individuals in the database (2016-2021), 39,280 had SG and 801,000 had the diagnosis of Choledocholithiasis.
Amongst SG patients, 5,670 (14.4%) individuals had a diagnosis of Choledocholithiasis, compared with 795,330 (2.3%) in those with no history of SG. When compared to general population, patients after SG were more likely to develop Choledocholithiasis [OR: 3.535; 95% CI 3.431-3.641, P < 0.0001]. predictors of Choledocholithiasis after SG were female gender, Caucasian race, young adults (age 18-65), Diabetes mellitus, obesity (BMI > 30), and Dyslipidemia.

Discussion: This large cohort study indicated a possible increase of 12.1% in the prevalence of Choledocholithiasis in patients after SG compared to those without previous history of SG. This possible increased risk could be due the higher risk of cholelithiasis in those patients or due to other reasons. Larger prospective studies are needed to further explore this possible association.

Figure: Multivariate analysis model (Choledocholithiasis after SG)

	SG 39,280	No SG 35,050,230
Adult (age between 18 and 65)	33,970	20675910
Senior (age greater than 65)	5,310	14374320
Female	31,450	19275030
Male	7,830	15775200
Caucasian	29,510	20655750
African American	7,550	4071530
Hispanic/Latino	630	374850
Asian	130	539290
Diabetes	14,850	3,736,640
smoking	8,540	4,783,450
alcohol abuse	780	627,090
Obesity BMI >30	13,030	1,572,660
Hypertension	25,250	8,689,160
Dyslipidemia	290	93,950

Table: Baseline characteristics of the study population

Disclosures:

Mohammad Abureesh indicated no relevant financial relationships.

Rawan Badran indicated no relevant financial relationships.

Motasem Alkhayyat indicated no relevant financial relationships.

Danyal Khan indicated no relevant financial relationships.

Aqsa Nisar indicated no relevant financial relationships.

Ahmad Abouyassine indicated no relevant financial relationships.

Ahmad Elfiky indicated no relevant financial relationships.

Loai Dahabra indicated no relevant financial relationships.

Sherif Andrawes indicated no relevant financial relationships.

Mohammad Abureesh, MD¹, Rawan Badran, MD¹, Motasem Alkhayyat, MD², Danyal Khan, MD¹, Aqsa Nisar, MD¹, Ahmad Abouyassine, MD¹, Ahmad Elfiky, MD¹, Loai Dahabra, MD¹, Sherif Andrawes, MD¹. P0019 - Prevalence of Choledocholithiasis Following Sleeve Gastrectomy, ACG 2021 Annual Scientific Meeting Abstracts. Las Vegas, Nevada: American College of Gastroenterology.