Routine cholecystectomy in the morbidly obese

Area of Science:

• Bariatric Surgery
• Gastroenterology
• Surgical Pathology

Background:

• Gallbladder disease is common in morbidly obese individuals.
• Weight reduction procedures may increase the risk of gallbladder pathology.
• Routine cholecystectomy during bariatric surgery is debated.

Purpose of the Study:

• To evaluate the incidence of gallbladder disease in morbidly obese patients undergoing vertical banded gastroplasty (VBG).
• To determine the benefit of routine cholecystectomy in this patient population.

Main Methods:

• A series of 51 consecutive patients undergoing VBG were studied.
• Gallbladders were routinely removed, irrespective of preoperative findings.
• Pathological examination of removed gallbladders was performed.

Main Results:

• Of 37 patients not pre-surgically treated for gallbladder issues, 73% had significant gallbladder disease.
• Cholelithiasis (29.7%) and cholesterolosis (29.7%) were the most common findings.
• Only 27% of patients had normal gallbladder findings.

Conclusions:

• A high incidence of gallbladder disease exists in morbidly obese patients undergoing VBG.
• Routine prophylactic cholecystectomy should be considered during VBG and similar procedures.
• This approach may mitigate risks of developing postoperative gallbladder disease.