Effect of timing of cholecystectomy on weight loss after sleeve gastrectomy in morbidly obese individuals with cholelithiasis: a retrospective cohort study

Abstract Objectives Obesity and gallbladder stone disease are strongly connected conditions. Nonetheless, the concomitant performance of cholecystectomy alongside sleeve gastrectomy remains contentious in individuals with asymptomatic gallstones. This study examines the impact of cholecystectomy timing on weight loss following sleeve gastrectomy. Methods A retrospective assessment was conducted on the records of 94 patients who underwent bariatric surgery from 2021 to 2025. The effect on weight loss (% EWL), insulin resistance, and other metabolic parameters was evaluated in patients who underwent concomitant cholecystectomy with sleeve gastrectomy, those who had cholecystectomy six months post-surgery, and those who received cholecystectomy prior to sleeve gastrectomy. Results Out of 94 patients, 29 (30.8 %) received concomitant cholecystectomy. It was established that patients who received late cholecystectomy experienced reduced complication rates, shorter hospital stays, and decreased operation times compared to other groups. Fasting glucose and insulin resistance levels were significantly reduced in the late group at the 3rd and 6th months, but they diminished at the 6th month in the contemporaneous group (p<0.05). The augmentation in EWL% was markedly superior in the late group relative to the other groups commencing from the third month (p<0.05). Conclusions Postponing the treatment of asymptomatic gallbladder disease after sleeve gastrectomy is both safe and may yield beneficial effects on weight reduction and insulin sensitivity.