Should Your Gallbladder Be Removed Prophylactically During Bariatric Surgery?

As you may know, while Dr. Huguet and Dr. Peterson are general surgeons performing a wide range of surgeries on common and complex abdominal conditions, they also specialize in bariatric or weight loss surgery. Bariatric surgery can be an effective option for patients suffering from obesity who have not seen improvement from years or even decades of diet and exercise, as well as non-surgical therapies like weight loss medication and structured diet programs. We are often asked about the potential for gallstone development in the early months after bariatric surgery when the patient loses significant weight. If you have researched gallbladder disease, you may know that one of the most significant risk factors for gallstones is rapid weight loss – exactly what happens after a bariatric procedure. So, the question is: should the gallbladder be removed regardless of symptoms during the primary bariatric procedure to avoid another surgery?

The short answer is no; there is not enough data to suggest that a gallbladder should be removed preemptively during a bariatric procedure if no symptoms of gallbladder disease are present. True, some patients will develop gallstones in the several months after bariatric surgery, but there are two things to consider.

First, if you follow your postoperative plan closely, you will stay well hydrated, which reduces the likelihood of developing gallstones. Also, moderate weight loss – i.e., not over-dieting- reduces your risk. Secondly, not all gallstones are symptomatic. In fact, only about 10% of patients with gallstones have symptomatic disease. So, even if you develop gallstones after a bariatric procedure, this does not necessarily mean your gallbladder will ever need to be removed.

What if I Have Symptomatic Gallbladder Disease Before Bariatric Surgery?

This presents a completely different scenario, of course. One of the other significant risk factors for gallbladder disease and symptomatic gallstones is excess weight and obesity. As such, many bariatric candidates have already had their gallbladders removed or are currently dealing with symptomatic gallstones. When this is the case, it may be appropriate to remove the gallbladder during the primary bariatric procedure to reduce the risk associated with a second later surgery, something that is virtually guaranteed since gallstone attacks tend to get worse over time.

Does Removing the Gallbladder Change My Bariatric Surgery Recovery?

Ultimately, the recovery from gallbladder removal is far less intense than that of a bariatric procedure. So, if your gallbladder is removed simultaneously, your recovery will not change. Depending on your circumstance, your surgeon may offer additional guidance. However, we typically do not change the course of your postoperative journey significantly.

If you are experiencing worsening gallbladder symptoms, you may require gallbladder surgery. If you are also suffering from obesity, you may wish to consider a bariatric procedure, and we encourage you to watch our online seminar to understand if surgery may be right for you and if you qualify. Most importantly, getting candid advice from bariatric and general surgeons like Dr. Huguet or Dr. Peterson is the first step in any treatment plan.