Gallstones are a frequent problem that occur 10% of the time after all weight loss surgery. They are typically caused by rapid weight loss, rather than an alteration in your bile or liver function. They may be slightly more common after gastric bypass surgery compared to the Sleeve Gastrectomy, only because there is more weight loss after gastric bypass. Some surgeons will prescribe Actigall, a medication that helps to thin the bile in an effort to prevent the formation of gallstones, however it is likely that this medication is only minimally effective and I do not typically prescribe it to my post operative patients.
In the early days of weight loss surgery, surgeons would routinely remove patients gallbladders at the same time as their surgery, this is no longer done by most surgeons. Before 2005, most weight loss surgery was done through a large incision in the abdomen which resulted in the formation of significant scar tissue that made subsequent removal of the gallbladder more difficult. Today, 99% of all weight loss surgeries are performed laparoscopically through 5-7 small incisions which results in very little scar formation making removal of the gallbladder no more difficult or dangerous than it is in those who have never had any abdominal surgery at all. Since 90% of all weight loss surgery patients do not develop gallstones, routine removal of the gallbladder is no longer recommended.
Nonetheless, any patient who develops abdominal pain or nausea after eating should consult with their bariatric surgeon to ensure that you have not developed gallstones. A simple ultrasound test will determine the presence of gallstones with 99% accuracy and gallbladder removal can usually be done on an outpatient basis.