Cholecystectomy increases the risk of dumping syndrome and postbariatric hypoglycemia after bariatric surgery

A Marrit van Furth*, Merel van den Broek, Marloes Emous, Loek J M de Heide, Folkert Kuipers, André P van Beek

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

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Background: Dumping syndrome (DS) and postbariatric hypoglycemia (PBH) are frequent complications of bariatric surgery. Bile acids (BA) have been implicated in their pathogenesis because both bariatric surgery and cholecystectomy (CCx) are known to modulate human BA metabolism.

Objectives: Our investigation aimed to compare the prevalence of self-reported complaints of DS and PBH in postbariatric patients with and without CCx.

Setting: A large peripheral hospital in the Netherlands.

Methods: All patients who underwent bariatric surgery in 2008-2011 received standardized questionnaires on DS/PBH complaints. The relative risk (RR) of CCx was calculated as the risk of perceived DS and PBH in patients with and without CCx.

Results: Of 590 participants, 146 (25%) had CCx before assessment of DS/PBH complaints. Participants were mostly female (82%) with median age of 46 years (interquartile range, 39-53). The RR for DS after CCx was higher in patients with body mass index = 70% (RR, 2.73; 95% CI, 1.57-4.77; P = .0004) with greater risk of DS. The RR for PBH was higher after CCx in sleeve gastrectomy patients (RR, 4.5; 95% CI, 1.00-20.3; P = .036).

Conclusion: High suspicion of DS and PBH after CCx is increased after bariatric surgery in certain subgroups, suggesting involvement of altered BA metabolism in their pathophysiology. (C) 2020 American Society for Bariatric Surgery. Published by Elsevier Inc.

Original languageEnglish
Pages (from-to)1939-1947
Number of pages9
JournalSurgery for obesity and related diseases : official journal of the American Society for Bariatric Surgery
Issue number12
Early online date25-Aug-2020
Publication statusPublished - Dec-2020


  • Cholecystectomy
  • Dumping syndrome
  • Postbariatric hypoglycemia
  • Bariatric surgery
  • Gastric bypass
  • Bile acids

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