Association Between Cholecystectomy and Gastroesophageal Inflammatory Findings After Sleeve Gastrectomy: Endoscopic and Metabolic Evaluation
In brief
Gastritis rose from 34% to 51% after gallbladder removal post-sleeve
In a retrospective study of 133 patients, gastritis became more common after cholecystectomy following sleeve gastrectomy, with moderate to severe cases rising from 12% to 23%. Esophagitis also increased over time, while metabolic measures continued to improve; the observational design cannot establish that gallbladder removal caused the inflammatory changes.
- Journal
- Obesity surgery (Q1)
- Published
- 26 September 2026
- Study design
- Retrospective cohort
- Evidence level
- Level 3, Low (CEBM 3b)
- Authors
- Gabriel Guerra Cordeiro, Vinícius Vasconcelos do Amaral, Luiz Alberto Reis Mattos Júnior, Flávio Kreimer, José Guido Correia de Araújo Júnior, Álvaro Antônio Bandeira Ferraz
- PMID
- 42791465
- DOI
- 10.1007/s11695-026-08947-0
Why clinicians should know about it
- Picked for Bariatric and Metabolic Surgery (paper of the day, 28 September 2026): Cholecystectomy post-sleeve gastrectomy increases gastritis severity
Abstract
INTRODUCTION: Sleeve gastrectomy (SG) is associated with the development or worsening of gastroesophageal reflux disease (GERD). Cholecystectomy following SG - the standard treatment for cholelithiasis resulting from rapid weight loss - may influence GERD pathophysiology by enhancing enterohepatic bile circulation and increasing alkaline reflux. OBJECTIVE: To investigate the longitudinal development of endoscopic and histologic esophageal and gastric mucosal findings, alongside systemic metabolic profiles, across defined pre- and post-cholecystectomy intervals in individuals previously managed with SG. METHODS: A longitudinal, retrospective, observational cohort study was conducted with 133 patients who underwent cholecystectomy after SG between 2009 and 2017. Endoscopic findings were analyzed at three time points: pre-SG, pre-cholecystectomy, and post-cholecystectomy. RESULTS: Compared with the pre-sleeve gastrectomy assessment, moderate esophagitis increased from 3.0% to 12.2% and severe esophagitis from 0.8% to 2.7% at the post-cholecystectomy evaluation. In contrast, the direct comparison between the pre- and post-cholecystectomy assessments demonstrated a significant increase in gastric inflammatory findings, particularly moderate gastritis. Gastritis prevalence increased from 33.9% to 51.4% (p < 0.05), with moderate to severe cases rising from 11.9% to 23.0% (p < 0.05). BMI and metabolic parameters (HbA1c, insulin, fasting glucose, cholesterol, triglycerides, uric acid, and C-peptide) improved significantly (p < 0.001). CONCLUSION: Cholecystectomy following sleeve gastrectomy was associated with an increased prevalence and severity of gastritis and a progressive trend in esophagitis over time, without compromising the long-term metabolic benefits of SG.
Abstract as published, via PubMed.
For healthcare professionals. The summary is generated by AI from the published abstract, and the evidence level is assigned automatically from the study design on the Oxford CEBM hierarchy. Neither is medical advice. Read the full paper before changing practice.