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Updated: Jun 17, 2026
Roux-en-Y Gastric Bypass Operation in Rats
Published on: June 11, 2012
Morbidity of cholecystectomy and gastric bypass in a national database
V Wanjura1, E Szabo1, J Österberg2
1Department of Surgery, Faculty of Medicine and Health, Örebro University, Örebro, Sweden.
Insights
For patients needing both procedures, gallbladder removal (cholecystectomy) should occur before Roux-en-Y gastric bypass (RYGB). Performing cholecystectomy after RYGB increases complication risks.
Area of Science:
- Bariatric Surgery
- Gastroenterology
- Surgical Outcomes
Background:
- Obesity is strongly linked to gallstone formation.
- Optimal surgical timing for concurrent Roux-en-Y gastric bypass (RYGB) and cholecystectomy is unclear.
Purpose of the Study:
- To determine the safest sequence for performing RYGB and cholecystectomy when both are indicated.
- To analyze complication and reoperation rates based on surgical order.
Main Methods:
- Retrospective analysis of Swedish national registries (GallRiks and SOReg) from 2007-2013.
- Involved 79,386 cholecystectomy and 36,098 RYGB patients.
- Compared complication rates, reoperation rates, and operation times based on procedure timing.
Main Results:
- Higher aggregate complication risk observed when cholecystectomy followed RYGB (OR 1.35).
- A complication from the first surgery increased the risk of the second (OR 2.02).
- Simultaneous procedures increased risk (OR 1.72) and operative time by ~60 minutes.
Conclusions:
- Cholecystectomy should be performed prior to RYGB.
- Performing cholecystectomy during or after RYGB is associated with increased risks.
- This sequence optimizes patient safety in combined bariatric and gallbladder surgery.
Background:
There is a strong association between obesity and gallstones. However, there is no clear evidence regarding the optimal order of Roux-en-Y gastric bypass (RYGB) and cholecystectomy when both procedures are clinically indicated.
Methods:
Based on cross-matched data from the Swedish Register for Cholecystectomy and Endoscopic Retrograde Cholangiopancreatography (GallRiks; 79 386 patients) and the Scandinavian Obesity Surgery Registry (SOReg; 36 098 patients) from 2007 to 2013, complication rates, reoperation rates and operation times related to the timing of RYGB and cholecystectomy were explored.
Results:
There was a higher aggregate complication risk when cholecystectomy was performed after RYGB rather than before (odds ratio (OR) 1·35, 95 per cent c.i. 1·09 to 1·68; P = 0·006). A complication after the first procedure independently increased the complication risk of the following procedure (OR 2·02, 1·44 to 2·85; P < 0·001). Furthermore, there was an increased complication risk when cholecystectomy was performed at the same time as RYGB (OR 1·72, 1·14 to 2·60; P = 0·010). Simultaneous cholecystectomy added 61·7 (95 per cent c.i. 56·1 to 67·4) min (P < 0·001) to the duration of surgery.
Conclusion:
Cholecystectomy should be performed before, not during or after, RYGB.
