Is the chance of developing gallbladder stones increased after gastric sleeve surgery?

Hi Vertedo,
Thank you for your great question — it’s very smart to be thinking ahead as you prepare for your vertical sleeve gastrectomy (VSG), also known as gastric sleeve surgery.
Yes, it’s true that the chance of developing gallstones after gastric sleeve surgery can increase, especially during the period of rapid weight loss. In our practice, we see about 5% of patients develop gallbladder issues after surgery. This happens because rapid weight loss can cause changes in the bile, making it easier for stones to form.
The good news is that when gallbladder problems do occur, they are typically very easy to resolve, often with a simple outpatient gallbladder removal surgery.
If you are concerned about gallstones, you may request a medication called Ursodiol, and we can have a conversation together to see if it’s a good fit for you and your concerns. Ursodiol can be very effective in helping prevent gallstone formation during the rapid weight loss phase.
Most importantly, the health benefits of gastric sleeve surgery — including improved heart health, better blood sugar control, reduced joint pain, and increased energy — far outweigh the small potential risk of developing gallbladder issues. You are making a powerful investment in your long-term health.
Wishing you the very best as you move forward — you’re taking a truly exciting step!
Dr. Keshavarzi

Taking ursodeoxycholic acid helps prevent gallstones, highly recommended, you will not regret it, if you have a family history of stones.

After VSG, there is an increased risk of developing gallstones because rapid weight loss can cause changes in bile composition, making it more likely for stones to form. This happens because the liver releases more cholesterol into bile, and since you’ll be eating less, the gallbladder won’t contract as often, allowing bile to sit longer, which promotes stone formation.
To reduce this risk, doctors often prescribe Ursodiol for about six months after surgery. Ursodiol helps prevent gallstones by lowering the cholesterol content in bile. Staying hydrated, following your surgeon's dietary plan, and staying active after surgery can also help reduce your risk. If you’re concerned, you should talk to your surgeon about whether Ursodiol is right for you and what other steps you can take to prevent stones.

Rapid weight loss after bariatric surgery (gastric sleeve) can increase the risk of developing gallstones, even if you haven’t had issues before.
The prophylactic use of Ursodiol (at least 500 mg daily) during the first 6 months postoperatively is effective in reducing the incidence of gallstone formation. However, not everyone develops stones, and your surgeon will assess if Ursodiol (Ursodeoxycholic acid) is right for you based on your individual case.
The effective daily dose of Ursodiol in each study ranged from 500 to 1,200 mg, and it may be considered at least during the period of rapid weight loss (first 3–6 months postoperatively) to decrease the incidence of symptomatic gallstones.

This is because the surgery can lead to changes in bile production and flow, which can increase the risk of stone formation.
Studies have shown that up to 35% of people who have gastric sleeve surgery will develop gallstones within 10 years. The risk is highest in the first two years after surgery.
There are a few things that you can do to reduce your risk of developing gallstones after gastric sleeve surgery:
Lose weight slowly and gradually. Losing weight too quickly can increase your risk of gallstones.Maintain a healthy diet. A healthy diet includes plenty of fruits, vegetables, and whole grains.Exercise regularly. Exercise helps to keep your gallbladder healthy and reduces the risk of gallstones.Take medication to prevent gallstones. Your doctor may prescribe medication to help prevent gallstones.If you develop gallstones after gastric sleeve surgery, you will likely need to have them removed. This can be done with surgery or with a procedure called endoscopic lithotripsy, which uses sound waves to break up the stones.
It is important to talk to your doctor about your risk of developing gallstones after gastric sleeve surgery. They can help you to take steps to reduce your risk and to identify any signs or symptoms of gallstones early on.

Hello, I hope you are well. Yes, there is an increased risk of developing gallstones after bariatric surgery because rapid weight loss changes the normal composition of bile. Ursodiol does help reduce the risk, although it is only prescibed for a specific patient population. You should get a routine abdominal sonography as part of your pre-op exams. There is also a propability that you already have asymptomatic gallstones as obesity is also a risk factor. In this case, you could get both procedures done concomittantlty. I hope this answer was useful.

The gallbladder stones incidence increase by 40% by losing weight by any means including any procedure