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Safety of concomitant cholecystectomy with laparoscopic sleeve gastrectomy and gastric bypass: a MBSAQIP analysis

Wood, Stephanie G., Kumar, Sandhya B., Dewey, Elizabeth, Lin, Matthew Y., Carter, Jonathan T.·2019·Surgery for Obesity and Related Diseases
DOI 10.1016/j.soard.2019.03.004
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Abstract

Background Gallstone disease occurs more commonly in the obese population and is often diagnosed during the preoperative evaluation for bariatric surgery. Objectives This study analyzed outcomes of laparoscopic gastric bypass (LGB) and laparoscopic sleeve gastrectomy (SG), with and without cholecystectomy (LC), using data from the Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program. Setting Patients reported to Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program participating centers in the United States and Canada in 2015. Methods All cases of LGB and SG, with and without LC, were analyzed. A 1:1 propensity-matched cohort was created for both SG and LGB, with and without concomitant LC. Multivariate logistic regression stratified by procedure was used to identify predictors of major complications after SG and LGB, using concomitant LC as a predictor. We also constructed a model for surgical site infections (SSIs) for SG group. Results Of 98,292 sleeve operations, 2046 (2%) had concomitant LC. Of 44,427 bypass operations, 1426 (3%) had concomitant LC. For the sleeve group, concomitant LC increased operative time by an average of 27 minutes but did not affect length of stay, mortality, or major complications. Concomitant LC was associated with increased SSI (1% versus .4%) and need for reoperation (1.6% versus .7%) in univariate models. After adjusting for other predictors, concomitant LC was associated with increased risk fo…

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Research works printed but not linked: 14

  1. Fobi, 2002, Prophylactic cholecystectomy with gastric bypass operation: incidence of gallbladder disease, Obes Surg, 12, 350, 10.1381/096089202321088138 · DOI
  2. Wudel, 2002, Prevention of gallstone formation in morbidly obese patients undergoing rapid weight loss: results of a randomized controlled pilot study, J Surg Res, 102, 50, 10.1006/jsre.2001.6322 · DOI · Paper page
  3. Shiffman, 1991, Gallstone formation after rapid weight loss: a prospective study in patients undergoing gastric bypass surgery for treatment of morbid obesity, Am J Gastroenterol, 86, 1000
  4. Liem, 2004, Prophylactic cholecystectomy with open gastric bypass operation, Obes Surg, 14, 763, 10.1381/0960892041590746 · DOI
  5. Nougou, 2008, Almost routine prophylactic cholecystectomy during laparoscopic gastric bypass is safe, Obes Surg, 18, 535, 10.1007/s11695-007-9368-8 · DOI
  6. Worni, 2012, Cholecystectomy concomitant with laparoscopic gastric bypass: a trend analysis of the nationwide inpatient sample from 2001 to 2008, Obes Surg, 22, 220, 10.1007/s11695-011-0575-y · DOI · Paper page
  7. Mechanick, 2013, Surg Obes Relat Dis, 9, 159, 10.1016/j.soard.2012.12.010 · DOI
  8. Dakour-Aridi, 2017, Safety of concomitant cholecystectomy at the time of laparoscopic sleeve gastrectomy: analysis of the American College of Surgeons National Surgical Quality Improvement Program database, Surg Obes Relat Dis, 13, 934, 10.1016/j.soard.2016.12.012 · DOI
  9. Morais, 2016, Gallstones and bariatric surgery: to treat or not to treat?, World J Surg, 40, 2904, 10.1007/s00268-016-3639-2 · DOI · Paper page
  10. Raziel, 2015, Concomitant cholecystectomy during laparoscopic sleeve gastrectomy, Surg Endosc, 29, 2789, 10.1007/s00464-014-4010-z · DOI
  11. Yardimci, 2018, Is concomitant cholecystectomy necessary for asymptomatic cholelithiasis during laparoscopic sleeve gastrectomy?, Obes Surg, 28, 469, 10.1007/s11695-017-2867-3 · DOI
  12. Altieri, 2018, Incidence of cholecystectomy after bariatric surgery, Surg Obes Relat Dis, 14, 992, 10.1016/j.soard.2018.03.028 · DOI
  13. Weiss, 2015, Concomitant cholecystectomy should be routinely performed with laparoscopic Roux-en-Y gastric bypass, Surg Endosc, 29, 3106, 10.1007/s00464-014-4033-5 · DOI
  14. Dorman, 2013, Does concomitant cholecystectomy at time of Roux-en-Y gastric bypass impact adverse operative outcomes?, Obes Surg, 23, 1718, 10.1007/s11695-013-1001-4 · DOI

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Metadata

Authors
Wood, S. G., Kumar, S. B., Dewey, E., Lin, M. Y., & Carter, J. T.
Venue
Surgery for Obesity and Related Diseases
Publisher
Elsevier BV
Published
2019-06
Volume
15
Issue
6
Pages
864-870
ISSN
1550-7289
DOI
10.1016/j.soard.2019.03.004
Cited by
40
References
0
Language
en
Licence

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