Changes in gallbladder motility and gallstone formation following laparoscopic gastric banding: DISCUSSION (Part 1)
Of the three patients who developed gallstones at six weeks, one required a cholecystectomy. Another still had stones at six months but had no symptoms. In the third patient, the gallstones disappeared and were not evident even on repeat ultrasonography. This latter patient exhibited an improved gallbladder emptying from 56.4% to 67.1%, while weight loss of 2.3% per week at six weeks fell to 0.3% per week by six months. This patient was also the only one of the three whose gallbladder volume, residual volume and refilling rate fell within the 95 percentile of the group at six weeks when gallstones were first detected.
Obese patients, as shown here, exhibited a significant increase in their gallbladder volume with the same per cent emptying response to CCK-8 as the controls, but yielded a significant increase in the gallbladder residual volume and refilling rate. The present study further demonstrates that very obese women who rapidly lose weight after laparoscopic gastric banding are at high risk for developing gallstones. Following such surgery, 27% (three of the 11 patients) acquired gallstones at six weeks. Their rate of weight loss was 1.7% of the total body weight per week for the six weeks following surgery. No further stones developed thereafter. Instead, one of the stones disappeared. All three patients exhibited a greater per cent weight loss per week and much reduced gallbladder emptying (outside the 95 percentile), compared with that of the obese patients without gallstone formation. Two out of the three patients differed from the others in terms of larger gallbladder fasting and residual volumes, and lower gallbladder refilling rates. The third patient was not different, and by six months, the gallstones had disappeared on ultrasound. At six months, all patients showed a trend towards their preoperative measurements. Spend less money now – buy viagra super active online for your efficient drug to cost less.