Cholecystectomy in morbidly obese patients

Area of Science:

• Bariatric Surgery
• Gastroenterology
• Surgical Oncology

Background:

• The decision to perform cholecystectomy concurrently with gastric bariatric surgery is debated.
• Current practices range from routine gallbladder removal to selective removal based on palpable stones or gross disease.

Purpose of the Study:

• To evaluate the safety and efficacy of simultaneous cholecystectomy during gastric bariatric operations.
• To compare operative times and postoperative outcomes between patients with and without simultaneous cholecystectomy.

Main Methods:

• Retrospective review of 724 patients undergoing gastric bariatric operations between 1975 and the present.
• Analysis of clinical records, anesthesia, pathology, and operative reports for 136 simultaneous cholecystectomies.
• Comparison of operative length and hospitalization duration.

Main Results:

• Simultaneous cholecystectomy was performed in 136 of 724 patients without significant prolongation of operation or hospitalization.
• No cases of postoperative choledocholithiasis were reported.
• One patient experienced a common bile duct stricture, a complication related to cholecystectomy.

Conclusions:

• Cholecystectomy should be performed concurrently with gastric bariatric operations in cases of gross or echogenic gallbladder disease.
• Simultaneous cholecystectomy is not significantly prolonged or complicated by the bariatric procedure.