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Concomitant Cholecystectomy During Laparoscopic Roux-en-Y Gastric Bypass in Obese Patients Is Not Justified: A Meta-Analysis

Warschkow, Rene, Tarantino, Ignazio, Ukegjini, Kristjan, Beutner, Ulrich, Güller, Ulrich, Schmied, Bruno M., Müller, Sascha A., Schultes, Bernd, Thurnheer, Martin·2013·Obesity Surgery
DOI 10.1007/s11695-012-0852-4
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Abstract

While LRYGB has become a cornerstone in the surgical treatment of morbidly obese patients, concomitant cholecystectomy during LRYGB remains a matter of debate. The aim of this meta-analysis was to estimate the rate and morbidity of subsequent cholecystectomy after laparoscopic Roux-en-Y gastric bypass (LRYGB) in obese patients. A meta-analysis was performed analyzing the rate and morbidity of subsequent cholecystectomy in patients who underwent LRYGB without concomitant cholecystectomy. Thirteen studies met the inclusion criteria. The rate of subsequent cholecystectomy was 6.8 % (95 % CI, 5.0-8.7 %) based on 6,048 obese patients who underwent LRYGB without concomitant cholecystectomy. The rate of subsequent cholecystectomy due to biliary colic or gallbladder dyskinesia was 5.3 %; due to cholecystitis, 1.0 %; choledocholithiasis, 0.2 %; and biliary pancreatitis, 0.2 %. The mortality after subsequent cholecystectomy was 0 % (95 % CI, 0-0.1 %). The surgery-related complication rate after subsequent cholecystectomy was 1.8 % (95 % CI, 0.7-3.4 %) resulting in a risk of 0.1 % (95 % CI, 0.03-0.3 %) to suffer from a cholecystectomy-related complication in patients undergoing LRYGB without concomitant cholecystectomy. A prophylactic concomitant cholecystectomy during LRYGB should be avoided in patients without cholelithiasis and exclusively be performed in patients with symptomatic biliary disease.

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Metadata

Authors
Warschkow, R., Tarantino, I., Ukegjini, K., Beutner, U., Güller, U., Schmied, B. M., Müller, S. A., Schultes, B., & Thurnheer, M.
Venue
Obesity Surgery
Publisher
Springer Science and Business Media LLC
Published
2013-01-12
Volume
23
Issue
3
Pages
397-407
ISSN
  • 0960-8923
  • 1708-0428
DOI
10.1007/s11695-012-0852-4
Cited by
135
References
0
Language
en
Licence
www.springer.com/tdm (tdm)

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