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Updated: Apr 19, 2026

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Concomitant cholecystectomy during laparoscopic sleeve gastrectomy.

Asnat Raziel1, Nasser Sakran, Amir Szold

  • 1Assia Medical Group, Assuta Medical Center, Tel Aviv, Israel.

Surgical Endoscopy
|December 7, 2014
PubMed
Summary

Concomitant cholecystectomy during laparoscopic sleeve gastrectomy (LSG) is safe for patients with symptomatic gallstones. Prophylactic removal of gallstones in asymptomatic patients undergoing LSG is not recommended.

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Area of Science:

  • Bariatric Surgery
  • Gastroenterology
  • Surgical Oncology

Background:

  • Cholelithiasis affects 19-45% of morbidly obese individuals.
  • Laparoscopic sleeve gastrectomy (LSG) is a common bariatric procedure.
  • Gallstone management during LSG is debated.

Purpose of the Study:

  • To evaluate the safety and outcomes of concomitant cholecystectomy with LSG.
  • To compare outcomes between patients with symptomatic cholelithiasis undergoing concomitant surgery versus LSG alone.
  • To assess the necessity of prophylactic cholecystectomy in LSG patients without gallstones.

Main Methods:

  • Retrospective study of patients undergoing LSG between 2006-2014.
  • Comparison of patients with symptomatic cholelithiasis (SC) undergoing concomitant surgery (SGC) versus LSG alone.

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  • Data collected: demographics, BMI, operative time, complications, length of stay, and subsequent gallbladder disease.

    • Main Results:

    • SGC patients were more likely female and older; operative time increased by 35 minutes.
    • No significant difference in BMI, length of stay, or overall complications.
    • 9.3% of asymptomatic cholelithiasis patients required cholecystectomy post-LSG versus 2.7% with normal gallbladders.

    Conclusions:

    • Concomitant cholecystectomy is safe and indicated for symptomatic cholelithiasis during LSG.
    • Prophylactic cholecystectomy for asymptomatic gallstones in LSG patients is unnecessary.
    • Optimal management of asymptomatic gallstones during LSG remains under discussion.