P4876 - A Comparative Study on Symptomatic Gallstones: The Impact of Rapid Weight Loss From Bariatric Surgery Versus GLP-1 Agonist Treatment

Rashid Abdel-Razeq, MD¹, Mohamad-Noor Abu-Hammour, MD², Aravinthan Vignarajah, MD³, Antoine Boustany, MD³, Kamal Hassan, MD⁴, Maysarah Jamil. Qapaja, MS⁵, Hassan Siddiki, MD^6
1Cleveland Clinic, Cleveland, OH; ²Cleveland Clinic Fairview, Cleveland, OH; ³Cleveland Clinic Foundation, Cleveland, OH; ⁴New York-Presbyterian/Queens, New York, NY; ⁵Cairo University School of Medicine, Cairo, Al Jizah, Egypt; ⁶Digestive Disease Institute, Cleveland Clinic, Cleveland, OH

Introduction: Rapid weight loss is a known risk factor for the development of gallstones. Bariatric surgery and the use of glucagon-like peptide-1 (GLP-1) agonists, such as liraglutide and semaglutide, are effective interventions for achieving rapid weight reduction in obese patients. However, the comparative risk of gallstone formation following these two weight-loss methods remains unclear. This study aims to evaluate and compare the incidence of symptomatic gallstones in patients undergoing bariatric surgery versus those using GLP-1 agonists.

Methods: A retrospective cohort study was conducted using data from the TriNetX network. The study population include patients who have been prescribed GLP-1 agonists (Cohort-1) or have undergone bariatric surgery for weight loss (Cohort-2). Patients included were followed for up to two years post-intervention to identify the incidence of gallstones. Relevant variables were extracted and analyzed to compare the outcomes between the two cohorts.

Results: Data analyzed was obtained from 120 health care organizations included in the Global Collaborative Network. Cohort-1 patients were extracted from 426,500 patients who matched the query criteria (age ≥18 years, BMI ≥ 35 kg/m², on GLP-1 agonists, but never had a bariatric surgery). Cohort-2 patients were extracted from a total of 140,553 similar patients who had a bariatric surgery, but never treated with GLP-1 agonists. Propensity score matching was performed on all characteristics and a total of 129,234 participant were identified in each cohort. Gallstones were diagnosed in 2,780 (2.15%) in GLP-1 users and in 5,512 (4.27%) following bariatric surgery, Hazard Ratio (HR)=0.652, (95%CI 0.622,0.682), p< 0.001. Cholecystitis was also less frequent in GLP-1 cohort (n=811, 0.63%) compared to cohort-2 (n=1,662, 1.29%), HR=0.638 (95%CI 0.586,0.694), p< 0.001. A total of 726 (0.56%) patients underwent cholecystectomy in cohort-1 compared to 1,821(1.4%) in cohort-2, HR=0.527 (95%CI 0.483,0.575), p< 0.001.

Discussion: Patients undergoing rapid weight reduction utilizing bariatric surgery are at higher risk for gallstones, cholecystitis and cholecystectomy compared to those utilize GLP-1 agonists for the same purpose.


Disclosures:


Rashid Abdel-Razeq, MD¹, Mohamad-Noor Abu-Hammour, MD², Aravinthan Vignarajah, MD³, Antoine Boustany, MD³, Kamal Hassan, MD⁴, Maysarah Jamil. Qapaja, MS⁵, Hassan Siddiki, MD⁶. P4876 - A Comparative Study on Symptomatic Gallstones: The Impact of Rapid Weight Loss From Bariatric Surgery Versus GLP-1 Agonist Treatment, ACG 2024 Annual Scientific Meeting Abstracts. Philadelphia, PA: American College of Gastroenterology.