Matthias Biebl - Academia.edu (original) (raw)
Papers by Matthias Biebl
Journal of the American College of Surgeons, 2015
The American Surgeon, Apr 1, 2010
This study aimed to evaluate outcome after liver resection for intrahepatic cholangiocarcinoma (I... more This study aimed to evaluate outcome after liver resection for intrahepatic cholangiocarcinoma (ICC). In a 72-month period a total of 25 patients operated on for ICC were followed-up with postoperatively. Eleven right hemihepatectomies (8 extended), seven left hemihepatectomies (3 extended), one segmental resection, two bisegmentectomies (II + III), and four nonanatomical resections were performed. Median observation period was 2.7 (range: 0.2-6.9) years. Analysis focused on age, gender, tumor-size, operating time, histologic resection margin, Tumor-Node-Metastasis-stage, reoperations, postoperative complications, tumor recurrence, survival rate and a putative relation between p53 accumulation, ki67 index, MUC1 positivity, and prognosis. Mean tumor size was 6.49 +/- 3.93 cm. Eighteen patients (72%) underwent lymph node dissection. Major postoperative complications occurred in 10 patients. Seventeen patients (68%) showed tumor recurrence. Mean time to tumor recurrence was 6.7 (5.7-15.4) months. We found no correlation between p53 accumulation/ki67 index counts/Mucin 1 cell surface associated antibody (MUC1) positivity and ICC prognosis. A total of 13 patients died (52%) including one early and 12 late deaths. Mean time from surgery to death was 14.6 (7.4-30.9) months. Survival rate at 1 year was 84 per cent, at 3 years 57 per cent, and at 5 years 45 per cent. In our review only a small number of these 25 patients are indeed cured.
Der Anaesthesist, May 1, 2005
The aim of the present investigation was to survey former participants (n=869) of a cadaver works... more The aim of the present investigation was to survey former participants (n=869) of a cadaver workshop using a mail questionnaire to assess the demographic data and the impact of these courses on daily practice. The deadline for acceptance of return mail was 60 days. Descriptive statistics were employed for analysis of results. The response rate was 36.7% and the course was judged to be recommendable by 98.2%. The average course attendant was board certified and had spent a mean time of 9+/-6 years in anesthesiology. The highest quality and degree of subsequent practicability in daily routine was attributed to peripheral nerve block training on cadavers. Of the course participants two-thirds performed regional anesthesia procedures more often following attendance. The majority of course attendants had to defray at least a part of the course fee themselves, and one-third was required to invest leisure time to attend. Attendance of a cadaver workshop increased knowledge of clinical anatomy and enhanced performance of regional anesthesia procedures. Courses of this format constitute a currently underestimated adjunct to contemporary regional anesthesia education.
Transplantation Journal, 2010
Mount Sinai Journal of Medicine a Journal of Translational and Personalized Medicine, Apr 1, 2005
To review the outcome of endovascular abdominal aortic aneurysm repair (EVAR) using commercial st... more To review the outcome of endovascular abdominal aortic aneurysm repair (EVAR) using commercial stent graft devices. Retrospective review of 167 EVAR procedures using different commercial devices at a single center between 1999 and 2003. Analysis included preoperative patient morbidities, operative and hospitalization data, postoperative complications, procedural outcome and midterm patient survival. Data are expressed as mean +/- SD and total number (%). P-values = 0.05 were considered significant. A total of 153 men and 14 women (mean age 75.0 +/- 7.3 years, range 53.1-89.2 years) underwent EVAR. Technical success rate was 97.0%. Postoperative intensive care unit stay was 0.05 +/- 0.24 days and hospital stay was 4 +/- 1.84 days. Postoperative complications occurred in 25 patients (15.0%). Two patients had to be readmitted within 30 days. Median follow-up time was 16.0 months (0-48 months). Overall mortality rate was 9.6% and did not depend on the type of endograft used (p=0.287). No early or aneurysm-related deaths or aneurysm ruptures occurred. Clinical success rate was 91.6% (153 patients). Graft limb thrombosis occurred in 5 patients (3.0%), all with the AneuRx device (p=0.041). Graft migration was seen in 3 devices (1.8%). There were 36 endoleaks (20.4%), specifically 30 branch vessel (type II) and 6 junctional (type I) endoleaks. Early endoleaks occurred in 21 patients (12.5%) and late endoleaks in 15 (9.0%). Twenty-two patients (13.0%) required secondary procedures (75.0% catheter-based vs. 25.0% surgical). Three patients (1.8%) underwent conversion to open aortic repair, 2 (1.0%) within the first year after EVAR. Aneurysm sac stabilization or shrinkage (> or = 5 mm reduction in transverse aneurysm diameter) occurred in 98.2% of patients; aneurysm shrinkage rate was 39.6% at 1 year, 68.74% at 2 years and 79.96% at 3 years after the procedure. Time to aneurysm shrinkage was longest with the AneuRx (1.96 +/- 0.18 years) and Talent (1.67 +/- 0.53 years) devices, compared to the Zenith (1.01 +/- 0.13 years), Ancure (0.95 +/- 0.14 years) and Excluder (0.25 +/- 0.17 years) stent grafts (p=0.0001). Endovascular aortic aneurysm repair using commercially manufactured devices is safe and effective, especially in patients at high risk for open aneurysm resection. While evolving endovascular experience has significantly decreased complication and secondary intervention rates, close long-term follow-up remains mandatory to detect late complications. Elective and unbiased use of all available surgical and interventional procedures is required to maintain long-term clinical success after EVAR.
Journal of the American College of Surgeons, 2010
Single-incision laparoscopic cholecystectomy (SILC) is emerging as a potentially less invasive al... more Single-incision laparoscopic cholecystectomy (SILC) is emerging as a potentially less invasive alternative to standard laparoscopic cholecystectomy and natural orifice transluminal endoscopic surgery cholecystectomy. As this technique is more widely used, it is important to maintain well-established practices of the critical view of safety (CVS) dissection and intraoperative cholangiography (IOC). We present our initial experience with SILC using CVS dissection and routine IOC. Fifty-four patients with biliary colic were offered SILC, which was performed through the umbilicus. CVS with photo documentation was attained before clipping and transecting the cystic structures. IOC was done using various needle puncture techniques. Assessment of CVS was carried out by independent surgeon review of operative still photos or videos using a 3-point grading scale: visualization of only 2 ductal structures entering the gallbladder; a clear triangle of Calot; and separation of the base of the gallbladder from the cystic plate. SILC was performed in 54 patients (15 male and 39 female). Six patients required 1 supplementary 3- or 5-mm port. Complete IOC was successful in 50 of 54 patients (92.6%). CVS was achieved at the time of operation in all 54 patients. Photo documentation review confirmed 3 of 3 CVS criteria in 32 (64%) patients, 2 of 3 in 12 patients (24%), 1 of 3 in 3 patients (6%), and 0 in 3 patients (6%). As laparoscopic cholecystectomy becomes less invasive, proven safe dissection techniques should be maintained. Dissection to obtain the CVS should be the goal of every patient and IOC can be accomplished in a high percentage of patients. This approach places patient safety considerations foremost in the evolution of minimally invasive cholecystectomy.
Mayo Clinic Proceedings, Jan 4, 2004
Transplantation Direct, 2015
Current Opinion in Organ Transplantation, 2015
With a persisting organ shortage and constant high discard rates, there is an urgent need to opti... more With a persisting organ shortage and constant high discard rates, there is an urgent need to optimize the outcome and allocation of marginal grafts. The Eurotransplant Senior Program was established as an 'old-for-old' allocation system emphasizing on the importance of keeping ischemic times short when utilizing marginal grafts. In addition to refined allocation systems, brief cold ischemic times, novel preservation techniques, a careful assessment of organ quality the utilization of dual kidney transplantation and donation after cardiac death kidneys from elderly donors may all help to increase the supply for renal transplantation. Moreover, age-adapted immunosuppression, improved patient selection and preparation for transplantation may help in improving outcomes when using marginal kidneys. There is a significant potential to increase the utilization of marginal grafts with reduced discard rates, an increased utilization of dual kidney transplantation and the application of novel preservation methods.
Annals of surgery
OBJECTIVE:: To evaluate the wound complication rate in patients undergoing transumbilical single-... more OBJECTIVE:: To evaluate the wound complication rate in patients undergoing transumbilical single-incision laparoscopic (SIL) surgery. BACKGROUND:: SIL surgery claims to be less invasive than conventional laparoscopy. Small SIL series have raised concerns toward a higher wound complication rate related to the transumbilical incision. METHODS:: In a 44-month period, 1145 consecutive SIL procedures were included. The outcomes were assessed according to the intention-to-treat analysis principle. All procedures were followed for a minimum of 6 months postoperatively, and wound complications were recorded as bleeding, infection (superficial/deep), or hernia. Patients were classified as having a wound complication or not. For all comparisons, significance level was set at P < 0.05. RESULTS:: Pure transumbilical SIL surgery was completed in 92.84%, and additional trocars were used in 7.16%. After a median follow-up of 22.1 (range, 7.67-41.11) months, 29 wound complications (2.53%) had oc...
Chirurgische Gastroenterologie, 2008
ABSTRACT Introduction: Liver resection is the treatment of choice for hepatocellular carcinoma (H... more ABSTRACT Introduction: Liver resection is the treatment of choice for hepatocellular carcinoma (HCC) in non-cirrhotic livers, whereas resections in cirrhotic livers remains a subject of controversy. Patients and Methods: Between October 2003 and August 2005 a total of 16 patients were operated for HCC. Patients with (group A, n = 10) or without cirrhosis (group B, n = 6) were compared using parametric and non-parametric tests as indicated. Significance is assumed if p < 0.05. Results: Tumor diameter was 7.44 (1.5–22) cm in group A and 11.25 (4.5–16) cm in group B. All but one patient of group B histologically had tumor-free margins. One patient had to be operated for bile leak (group A), one for bleeding and another one for a leak of the hepaticojejunostomy (both group B). During the observation period of 22.5 months, 1 patient in each group died. Tumor recurrence was seen in 3 patients in each group after 16.2 ± 2 months. One of them underwent re-operation. Conclusion: Liver resection for HCC is feasible even in cirrhotic livers with a low complication but high tumor recurrence rate. For cirrhotic patients with sufficient liver function, resection represents the only option if the patient does not meet the criteria for transplantation. Moreover, small tumors can be resected to delay transplantation, provided that functional capacity has been properly assessed.
Clinical Transplantation, 2015
Incisional hernia is a common complication after liver transplantation. Immunosuppression, obesit... more Incisional hernia is a common complication after liver transplantation. Immunosuppression, obesity and use of steroids are known risk factors. The purpose of the retrospective study was to summarize and evaluate experiences and results of laparoscopic intraperitoneal onlay mesh (IPOM) hernia repair. We reviewed our liver transplant patients over a 7-year period with laparoscopic incisional hernia repair (LIHR) to direct our attention on risk factors for hernia recurrence after hernia repair. 54 patients after liver transplantation with incisional hernia were treated with laparoscopic repair, 42 male and 12 female patients of overall mean age of 58±9 years and body mass index of 25±4 kg/m(2) . 755 liver transplantations were performed at our institution in this time period, resulting in 7.15% of patients undergoing laparoscopic hernia repair. The mean postoperative hospital stay after was 9 days. During the follow up 9 recurrent hernias were noted (17%). Body mass index (BMI) (p=0.001) and sirolimus as immunosuppressive therapy were significantly associated with hernia recurrence (p=0.014). Laparoscopic incisional hernia repair is a safe and feasible method to treat hernias after liver transplantation. BMI and sirolimus as immunosuppressive therapy are risk factors for recurrence of hernia after laparoscopic hernia repair. This article is protected by copyright. All rights reserved.
Transplantation Journal, 2010
Obesity surgery, Jan 15, 2015
Rapid weight loss is a risk factor for gallstone formation, and postoperative treatment options f... more Rapid weight loss is a risk factor for gallstone formation, and postoperative treatment options for gallstone formation are still part of scientific discussion. No prospective studies monitored the incidence for gallstone formation and subsequent cholecystectomy after bariatric surgery longer than 5 years. The aim of the study was to determine the incidence of gallstone formation and cholecystectomy in bariatric patients over 10 years. One hundred nine patients were observed over 10 years after laparoscopic gastric banding or gastric bypass/gastric sleeve. The incidence of gallstone formation and cholecystectomy was correlated to longitudinal changes in anthropometric parameters. In total, 91 female and 18 male patients were examined. Nineteen patients had postoperative gallstone formation, and 12 female patients required cholecystectomy. The number needed to harm for gallstone formation was 7.1 and 2.3 cases in the banding group and gastric bypass/gastric sleeve group, respectively...
Journal of the American College of Surgeons, 2015
The American Surgeon, Apr 1, 2010
This study aimed to evaluate outcome after liver resection for intrahepatic cholangiocarcinoma (I... more This study aimed to evaluate outcome after liver resection for intrahepatic cholangiocarcinoma (ICC). In a 72-month period a total of 25 patients operated on for ICC were followed-up with postoperatively. Eleven right hemihepatectomies (8 extended), seven left hemihepatectomies (3 extended), one segmental resection, two bisegmentectomies (II + III), and four nonanatomical resections were performed. Median observation period was 2.7 (range: 0.2-6.9) years. Analysis focused on age, gender, tumor-size, operating time, histologic resection margin, Tumor-Node-Metastasis-stage, reoperations, postoperative complications, tumor recurrence, survival rate and a putative relation between p53 accumulation, ki67 index, MUC1 positivity, and prognosis. Mean tumor size was 6.49 +/- 3.93 cm. Eighteen patients (72%) underwent lymph node dissection. Major postoperative complications occurred in 10 patients. Seventeen patients (68%) showed tumor recurrence. Mean time to tumor recurrence was 6.7 (5.7-15.4) months. We found no correlation between p53 accumulation/ki67 index counts/Mucin 1 cell surface associated antibody (MUC1) positivity and ICC prognosis. A total of 13 patients died (52%) including one early and 12 late deaths. Mean time from surgery to death was 14.6 (7.4-30.9) months. Survival rate at 1 year was 84 per cent, at 3 years 57 per cent, and at 5 years 45 per cent. In our review only a small number of these 25 patients are indeed cured.
Der Anaesthesist, May 1, 2005
The aim of the present investigation was to survey former participants (n=869) of a cadaver works... more The aim of the present investigation was to survey former participants (n=869) of a cadaver workshop using a mail questionnaire to assess the demographic data and the impact of these courses on daily practice. The deadline for acceptance of return mail was 60 days. Descriptive statistics were employed for analysis of results. The response rate was 36.7% and the course was judged to be recommendable by 98.2%. The average course attendant was board certified and had spent a mean time of 9+/-6 years in anesthesiology. The highest quality and degree of subsequent practicability in daily routine was attributed to peripheral nerve block training on cadavers. Of the course participants two-thirds performed regional anesthesia procedures more often following attendance. The majority of course attendants had to defray at least a part of the course fee themselves, and one-third was required to invest leisure time to attend. Attendance of a cadaver workshop increased knowledge of clinical anatomy and enhanced performance of regional anesthesia procedures. Courses of this format constitute a currently underestimated adjunct to contemporary regional anesthesia education.
Transplantation Journal, 2010
Mount Sinai Journal of Medicine a Journal of Translational and Personalized Medicine, Apr 1, 2005
To review the outcome of endovascular abdominal aortic aneurysm repair (EVAR) using commercial st... more To review the outcome of endovascular abdominal aortic aneurysm repair (EVAR) using commercial stent graft devices. Retrospective review of 167 EVAR procedures using different commercial devices at a single center between 1999 and 2003. Analysis included preoperative patient morbidities, operative and hospitalization data, postoperative complications, procedural outcome and midterm patient survival. Data are expressed as mean +/- SD and total number (%). P-values = 0.05 were considered significant. A total of 153 men and 14 women (mean age 75.0 +/- 7.3 years, range 53.1-89.2 years) underwent EVAR. Technical success rate was 97.0%. Postoperative intensive care unit stay was 0.05 +/- 0.24 days and hospital stay was 4 +/- 1.84 days. Postoperative complications occurred in 25 patients (15.0%). Two patients had to be readmitted within 30 days. Median follow-up time was 16.0 months (0-48 months). Overall mortality rate was 9.6% and did not depend on the type of endograft used (p=0.287). No early or aneurysm-related deaths or aneurysm ruptures occurred. Clinical success rate was 91.6% (153 patients). Graft limb thrombosis occurred in 5 patients (3.0%), all with the AneuRx device (p=0.041). Graft migration was seen in 3 devices (1.8%). There were 36 endoleaks (20.4%), specifically 30 branch vessel (type II) and 6 junctional (type I) endoleaks. Early endoleaks occurred in 21 patients (12.5%) and late endoleaks in 15 (9.0%). Twenty-two patients (13.0%) required secondary procedures (75.0% catheter-based vs. 25.0% surgical). Three patients (1.8%) underwent conversion to open aortic repair, 2 (1.0%) within the first year after EVAR. Aneurysm sac stabilization or shrinkage (&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;gt; or = 5 mm reduction in transverse aneurysm diameter) occurred in 98.2% of patients; aneurysm shrinkage rate was 39.6% at 1 year, 68.74% at 2 years and 79.96% at 3 years after the procedure. Time to aneurysm shrinkage was longest with the AneuRx (1.96 +/- 0.18 years) and Talent (1.67 +/- 0.53 years) devices, compared to the Zenith (1.01 +/- 0.13 years), Ancure (0.95 +/- 0.14 years) and Excluder (0.25 +/- 0.17 years) stent grafts (p=0.0001). Endovascular aortic aneurysm repair using commercially manufactured devices is safe and effective, especially in patients at high risk for open aneurysm resection. While evolving endovascular experience has significantly decreased complication and secondary intervention rates, close long-term follow-up remains mandatory to detect late complications. Elective and unbiased use of all available surgical and interventional procedures is required to maintain long-term clinical success after EVAR.
Journal of the American College of Surgeons, 2010
Single-incision laparoscopic cholecystectomy (SILC) is emerging as a potentially less invasive al... more Single-incision laparoscopic cholecystectomy (SILC) is emerging as a potentially less invasive alternative to standard laparoscopic cholecystectomy and natural orifice transluminal endoscopic surgery cholecystectomy. As this technique is more widely used, it is important to maintain well-established practices of the critical view of safety (CVS) dissection and intraoperative cholangiography (IOC). We present our initial experience with SILC using CVS dissection and routine IOC. Fifty-four patients with biliary colic were offered SILC, which was performed through the umbilicus. CVS with photo documentation was attained before clipping and transecting the cystic structures. IOC was done using various needle puncture techniques. Assessment of CVS was carried out by independent surgeon review of operative still photos or videos using a 3-point grading scale: visualization of only 2 ductal structures entering the gallbladder; a clear triangle of Calot; and separation of the base of the gallbladder from the cystic plate. SILC was performed in 54 patients (15 male and 39 female). Six patients required 1 supplementary 3- or 5-mm port. Complete IOC was successful in 50 of 54 patients (92.6%). CVS was achieved at the time of operation in all 54 patients. Photo documentation review confirmed 3 of 3 CVS criteria in 32 (64%) patients, 2 of 3 in 12 patients (24%), 1 of 3 in 3 patients (6%), and 0 in 3 patients (6%). As laparoscopic cholecystectomy becomes less invasive, proven safe dissection techniques should be maintained. Dissection to obtain the CVS should be the goal of every patient and IOC can be accomplished in a high percentage of patients. This approach places patient safety considerations foremost in the evolution of minimally invasive cholecystectomy.
Mayo Clinic Proceedings, Jan 4, 2004
Transplantation Direct, 2015
Current Opinion in Organ Transplantation, 2015
With a persisting organ shortage and constant high discard rates, there is an urgent need to opti... more With a persisting organ shortage and constant high discard rates, there is an urgent need to optimize the outcome and allocation of marginal grafts. The Eurotransplant Senior Program was established as an &amp;amp;amp;amp;amp;#39;old-for-old&amp;amp;amp;amp;amp;#39; allocation system emphasizing on the importance of keeping ischemic times short when utilizing marginal grafts. In addition to refined allocation systems, brief cold ischemic times, novel preservation techniques, a careful assessment of organ quality the utilization of dual kidney transplantation and donation after cardiac death kidneys from elderly donors may all help to increase the supply for renal transplantation. Moreover, age-adapted immunosuppression, improved patient selection and preparation for transplantation may help in improving outcomes when using marginal kidneys. There is a significant potential to increase the utilization of marginal grafts with reduced discard rates, an increased utilization of dual kidney transplantation and the application of novel preservation methods.
Annals of surgery
OBJECTIVE:: To evaluate the wound complication rate in patients undergoing transumbilical single-... more OBJECTIVE:: To evaluate the wound complication rate in patients undergoing transumbilical single-incision laparoscopic (SIL) surgery. BACKGROUND:: SIL surgery claims to be less invasive than conventional laparoscopy. Small SIL series have raised concerns toward a higher wound complication rate related to the transumbilical incision. METHODS:: In a 44-month period, 1145 consecutive SIL procedures were included. The outcomes were assessed according to the intention-to-treat analysis principle. All procedures were followed for a minimum of 6 months postoperatively, and wound complications were recorded as bleeding, infection (superficial/deep), or hernia. Patients were classified as having a wound complication or not. For all comparisons, significance level was set at P < 0.05. RESULTS:: Pure transumbilical SIL surgery was completed in 92.84%, and additional trocars were used in 7.16%. After a median follow-up of 22.1 (range, 7.67-41.11) months, 29 wound complications (2.53%) had oc...
Chirurgische Gastroenterologie, 2008
ABSTRACT Introduction: Liver resection is the treatment of choice for hepatocellular carcinoma (H... more ABSTRACT Introduction: Liver resection is the treatment of choice for hepatocellular carcinoma (HCC) in non-cirrhotic livers, whereas resections in cirrhotic livers remains a subject of controversy. Patients and Methods: Between October 2003 and August 2005 a total of 16 patients were operated for HCC. Patients with (group A, n = 10) or without cirrhosis (group B, n = 6) were compared using parametric and non-parametric tests as indicated. Significance is assumed if p < 0.05. Results: Tumor diameter was 7.44 (1.5–22) cm in group A and 11.25 (4.5–16) cm in group B. All but one patient of group B histologically had tumor-free margins. One patient had to be operated for bile leak (group A), one for bleeding and another one for a leak of the hepaticojejunostomy (both group B). During the observation period of 22.5 months, 1 patient in each group died. Tumor recurrence was seen in 3 patients in each group after 16.2 ± 2 months. One of them underwent re-operation. Conclusion: Liver resection for HCC is feasible even in cirrhotic livers with a low complication but high tumor recurrence rate. For cirrhotic patients with sufficient liver function, resection represents the only option if the patient does not meet the criteria for transplantation. Moreover, small tumors can be resected to delay transplantation, provided that functional capacity has been properly assessed.
Clinical Transplantation, 2015
Incisional hernia is a common complication after liver transplantation. Immunosuppression, obesit... more Incisional hernia is a common complication after liver transplantation. Immunosuppression, obesity and use of steroids are known risk factors. The purpose of the retrospective study was to summarize and evaluate experiences and results of laparoscopic intraperitoneal onlay mesh (IPOM) hernia repair. We reviewed our liver transplant patients over a 7-year period with laparoscopic incisional hernia repair (LIHR) to direct our attention on risk factors for hernia recurrence after hernia repair. 54 patients after liver transplantation with incisional hernia were treated with laparoscopic repair, 42 male and 12 female patients of overall mean age of 58±9 years and body mass index of 25±4 kg/m(2) . 755 liver transplantations were performed at our institution in this time period, resulting in 7.15% of patients undergoing laparoscopic hernia repair. The mean postoperative hospital stay after was 9 days. During the follow up 9 recurrent hernias were noted (17%). Body mass index (BMI) (p=0.001) and sirolimus as immunosuppressive therapy were significantly associated with hernia recurrence (p=0.014). Laparoscopic incisional hernia repair is a safe and feasible method to treat hernias after liver transplantation. BMI and sirolimus as immunosuppressive therapy are risk factors for recurrence of hernia after laparoscopic hernia repair. This article is protected by copyright. All rights reserved.
Transplantation Journal, 2010
Obesity surgery, Jan 15, 2015
Rapid weight loss is a risk factor for gallstone formation, and postoperative treatment options f... more Rapid weight loss is a risk factor for gallstone formation, and postoperative treatment options for gallstone formation are still part of scientific discussion. No prospective studies monitored the incidence for gallstone formation and subsequent cholecystectomy after bariatric surgery longer than 5 years. The aim of the study was to determine the incidence of gallstone formation and cholecystectomy in bariatric patients over 10 years. One hundred nine patients were observed over 10 years after laparoscopic gastric banding or gastric bypass/gastric sleeve. The incidence of gallstone formation and cholecystectomy was correlated to longitudinal changes in anthropometric parameters. In total, 91 female and 18 male patients were examined. Nineteen patients had postoperative gallstone formation, and 12 female patients required cholecystectomy. The number needed to harm for gallstone formation was 7.1 and 2.3 cases in the banding group and gastric bypass/gastric sleeve group, respectively...