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Laparoscopic cholecystectomy after bariatric surgery
S Papavramidis1, N Deligianidis, T Papavramidis
13rd Department of Surgery, Aristotelian University of Thessaloniki, S. Kyriakidi 1, AHEPA Hospital, Thessaloniki, Macedonia, Greece.
Background:
This prospective study determines the value of laparoscopic cholecystectomy (LC) in patients with cholelithiasis after bariatric surgery.
Methods:
Eighty-four consecutive patients who underwent bariatric surgery without concomitant cholecystectomy were studied. Patients were divided in two groups; group A including 50 patients (59.5%) without gallbladder disease, and group B included 34 patients (40.5%) with symptomatic cholelithiasis within 2 years postoperatively. Characteristics of both groups were compared and analyzed by the use of chi-square tests.
Results:
In all 34 patients in group B LC was attempted, and the procedure was successful in 28 (82.4%). LC was converted to open procedure in 6 patients (17.6%). Two patients with choledocholithiasic obstructive jaundice underwent endoscopic retrograde cholangiopancreatography and endoscopic sphincterotomy prior to laparoscopic management. The mean operative time was 75 +/- 12 min, and the mean hospitalization was 2.8 +/- 1.1 days.
Conclusion:
Morbidly obese patients undergoing bariatric surgery are at high risk for developing symptomatic cholelithiasis postoperatively, which usually takes the form of acute cholecystitis. LC is feasible, effective, and seems to be the procedure of choice despite the technical difficulties.
