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Gallbladder disease in the morbidly obese.

J F Amaral, W R Thompson

    American Journal of Surgery
    |April 1, 1985
    PubMed
    Summary

    Morbidly obese patients undergoing gastric exclusion surgery have a high incidence of gallbladder disease, often undetected by standard tests. Routine gallbladder removal during this surgery is recommended to prevent complications.

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    Area of Science:

    • Gastroenterology
    • Bariatric Surgery
    • Hepatobiliary Surgery

    Background:

    • Gallbladder disease is a known complication in morbidly obese individuals.
    • The prevalence and diagnostic accuracy of gallbladder disease in patients undergoing gastric exclusion surgery require further investigation.

    Purpose of the Study:

    • To determine the incidence of gallbladder disease in morbidly obese patients undergoing gastric exclusion.
    • To evaluate the accuracy of preoperative diagnostic studies for gallbladder disease in this population.
    • To assess the rate of postoperative gallbladder disease.

    Main Methods:

    • A retrospective review of 200 consecutive morbidly obese patients who underwent gastric exclusion surgery over a 7-year period.
    • Patients were divided into two groups: Group A (first 120) and Group B (last 80).
    • Group B underwent routine cholecystectomy concurrently with gastric exclusion surgery; gallbladder histology was examined.

    Main Results:

    • Gallbladder disease was present in 91.3% of the morbidly obese patients studied.
    • Preoperative diagnostic studies (ultrasonography, oral cholecystography) were frequently inaccurate, with 85.1% of patients with normal studies showing abnormal histology.
    • Postoperative gallbladder disease occurred in 28.7% of patients in Group A who did not have concurrent cholecystectomy.

    Conclusions:

    • Gallbladder disease is significantly more prevalent in morbidly obese patients than previously recognized.
    • Standard diagnostic tests for gallbladder disease have limited accuracy in this patient group.
    • Routine prophylactic cholecystectomy at the time of gastric exclusion surgery is recommended to mitigate the high risk of gallbladder pathology.

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