Objectives: the aim of this study was to evaluate the efficacy of combined laparoscopic surgery for non-complicated cholelithiasis and gastroesophageal reflux disease (GERD) in patients with low surgical risk.Methods: a total of 680 cholecystectomies performed by means of laparoscopic surgery were retrospectively studied from February 1991 to February 2002. A total of 442 patients that fulfilled the inclusion criteria were divided into two groups: group A: non-complicated cholelithiasis (cholecystectomy alone), consisting of a total of 362 patients, and group B: non-complicated cholelithiasis and GERD (cholecystectomy and Toupet's fundoplication in all cases) in 80 patients. Demographic and clinical data, intraoperatory incidences, and post-surgical complications were prospectively collected and compared for all patients. The results of reflux surgery (group B) were evaluated at 6 months by means of 24-hour pH-metry.Results: in spite of the fact that the group undergoing combined surgery consisted of patients with greater weight and older age (p < 0.05), no significant differences were found in the number of intraoperative incidences and post-surgical complications between both groups (NS). Significant differences were only found in the duration of surgery: 48 ± 25 min (10-150) in group A compared to 112 ± 23 min (80-180) in group B (p<0.001), and in the return to normal daily activities (5.8 ± 0.9 days vs 6.5 ± 1 days in group B) (p< 0.001). In the latter group a normalization of 24-hour pH-metry values and an absence of symptoms associated with reflux were observed in all cases.Conclusions: in patients younger than 75 years with low surgical risk and non-complicated cholelithiasis and GERD, both illnesses can be resolved during the same surgical procedure by laparoscopy with no increased risk or postoperative complications.

Surgical laparoscopic treatment with the Toupet technique is effective both clinically and functionally. In cases of relapse, a new repair is possible with laparoscopy. Long-term follow-up of these patients is necessary to show whether these results are maintained over time.

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Resumen Entre las complicaciones de la apendicectomía podemos encontrar el dolor postoperatorio que habitualmente se relaciona con problemas locales de la herida operatoria o a más largo plazo con el desarrollo de una hernia inguinal. Presentamos un caso de un paciente apendicectomizado que presentó un dolor agudo a nivel inguinal derecho sin complicaciones locales ni evidencia de hernia u otra patología intraabdominal en las pruebas de imagen.