Comparative Risk of Gallstone Formation After Sleeve Gastrectomy and Roux-En-Y Gastric Bypass: A Systematic Review and Meta-Analysis

Silva-Chavez W.; Bustamante-Cabrejo A.; Caballero-Alvarado J.; Lau-Torres V.; Sarmiento-Falen J.; Zavaleta-Corvera C. · Obesity Surgery (2025) · DOI: 10.1007/s11695-025-08388-1

Resumen

Objective: To compare the risk of gallstone formation after sleeve gastrectomy (SG) versus Roux-en-Y gastric bypass (RYGB). Methods: We searched PubMed, Scopus, Web of Science, and Embase following PRISMA 2020. Eligible observational studies reported incident cholelithiasis after SG or RYGB. Risk of bias was assessed with the Newcastle–Ottawa Scale (NOS). Pooled odds ratios (ORs) with 95% confidence intervals (CIs) were estimated using random-effects (DerSimonian–Laird). Prespecified subgroup analyses considered follow-up duration (< 2 vs. ≥ 2 years). Results: Ten studies (n = 195,665) met inclusion criteria. Overall, SG was associated with a lower risk of gallstone formation than RYGB (OR 0.68, 95% CI 0.53–0.88; p = 0.003; I²=75%). The protective association was evident in studies with < 2 years of follow-up (OR 0.59, 95% CI 0.42–0.82; I²=46%) but not in ≥ 2-year follow-up (OR 0.84, 95% CI 0.55–1.28; I²=70%). In influence analysis excluding the largest database study, the summary effect became statistically non-significant with extreme heterogeneity (OR 0.31, 95% CI 0.03–2.72; I²=99%). Methodological quality was moderate to high (NOS 6–8/9). Conclusions: SG is associated with a lower short-term risk of gallstone formation compared with RYGB, although results are heterogeneous and sensitive to study weight. Standardized outcome definitions, longer follow-up, and stratification by UDCA use are needed to refine comparative risk estimates. © The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature 2025.

Instituciones: Universidad Nacional de Trujillo; Universidad Científica del Sur; Universidad Privada Antenor Orrego