Gallstone Management in Patients Undergoing Laparoscopic Sleeve Gastrectomy

Area of Science:

• Bariatric Surgery
• Gastroenterology
• Surgical Management of Gallstones

Background:

• Gallstone management in bariatric surgery patients is debated.
• Laparoscopic sleeve gastrectomy (LSG) is a common bariatric procedure.
• Gallstone disease (GSD) and postoperative gallstone development are key considerations.

Purpose of the Study:

• To evaluate the management of GSD in LSG patients.
• To assess the incidence of postoperative gallstones after LSG.
• To compare outcomes of simultaneous cholecystectomy (SCC) versus conservative management.

Main Methods:

• Retrospective analysis of LSG patients (Oct 2020 - Nov 2023).
• Data collected: demographics, gallbladder status, operative details, complications.
• SCC performed for symptomatic GSD and on consenting asymptomatic patients.

Main Results:

• 391/2930 (13.34%) LSG patients had GSD.
• SCC in 142 patients; increased operative time by ~35 min, no increased complications.
• Postoperative gallstones: 6.3% in gallstone-free, 4.95% in asymptomatic GSD patients declining SCC.

Conclusions:

• SCC is safe but increases operative time.
• Postoperative gallstone formation is a concern, particularly in asymptomatic GSD patients.
• Preoperative counseling is crucial to discuss potential cholecystectomy needs post-LSG.