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Cholecystectomy During Laparoscopic Roux-en-Y Gastric Bypass
About Gallstones Prevention
Elective Cholecystectomy During Laparoscopic Roux-en-Y Gastric Bypass - Is it Worth the Wait?
Combined gastric bypass and cholecystectomy have been advocated for open bariatric procedures. Our goal was to evaluate the safety of this technique in laparoscopic bariatric surgery patients with gallstones diagnosed preoperatively.
94 out of 556 consecutive morbidly obese patients (16.9%) underwent laparoscopic gastric bypass with simultaneous cholecystectomy (laparoscopic gastric bypass /LC) for cholelithiasis.
328 patients (59%) had a concomitant secondary procedure, most commonly cholecystectomy (28.7%). Preoperative BMI was 48.6 +/- 6.9 kg/m2 for laparoscopic gastric bypass /LC patients and 48.8 +/- 7.3 kg/m2 for laparoscopic gastric bypass alone. 5 patients had preoperative biliary colic; the others were asymptomatic for cholelithiasis. Postoperatively, at a mean follow-up of 7.6 +/- 6.7 months, the percent excess weight loss (%EWL) was 46.1 +/- 0.25 for the combined procedure vs 50.2 +/- 63.0 for LGBP alone. There were no conversions to open procedures for the LC. Port placement for the LGBP was not altered for LC. None required intraoperative cholangiography. Operative time for the combined procedure was 293.4 +/- 79.8 minutes vs 244.8 +/- 77.2 minutes for laparoscopic gastric bypass alone. Length of stay for the combined procedure was 4.35 +/- 10.8 days vs 2.69 +/- 1.8 days for laparoscopic gastric bypass alone. There were no postoperative bile leaks or bile duct injuries.
Concomitant laparoscopic gastric bypass /LC is safe and feasible without altering port placement. Combining these procedures significantly increases operative time and nearly doubles the hospital stay.
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Laparoscopic or open bariatric surgery, such as gastric banding or bypass is not an easy solution to morbid obesity and weight loss. It is a serious surgical procedure, involving health risks. To produce lasting weight loss it requires a long-term patient commitment to eating a healthy diet and following a regular program of physical exercise. Life-long use of nutritional supplements may also be necessary. So, before deciding, discuss your options fully with your doctor. © 2003-2017 Bariatric-Surgery.Info - Terms - Contact - Information - Resources