Title : Hypertension as a novel predictive marker for symptomatic cholelithiasis in post-bariatric patients: Coincidence or causation?
Abstract:
Introduction: As obesity is well known to be associated with gallstone pathology, new advances have shown the role hypertension may play in predicting the occurrence of the latter. This study analyzes the correlation between symptomatic cholelithiasis post-bariatric surgery and hypertension.
Methods: Our study applied a retrospective cohort design, where 3000 Lebanese patients who underwent bariatric surgery, were selected from a single center, at Al Zahraa University Hospital from the years 2008 till 2018. 485 patients have been documented to have hypertension. Chi-square testing was employed to correlate symptomatic cholelithiasis incidence with subsequent cholecystectomy with hypertension status.
Discussion: Our data showed a significant association between hypertension and symptomatic gallstones (p = 0.021). While causation can not be concluded, this possible interaction may stem from common metabolic pathways regarding bile composition and cholesterol homeostasis. Our findings shed light on the added value of emphasizing hypertension as a variable in risk models. Such an emphasis in the management of bariatric cases may bring some surgical scenarios as better and safer options such as concomitant cholecystectomy during bariatric or redo surgeries.
Conclusion: Hypertension may sometimes be overlooked as a potential marker for the risk of gallstone occurrences post bariatric surgery. This study opens the door for further investigations as more data and evidences is required to properly decorticate the intensity of the association or causation between hypertension and gallstone formations, especially with bariatric surgeries, which may be seen as a synergistic component to the occurrence of cholelithiasis.
