Potential Benefits of Prophylactic Cholecystectomy in Patients Undergoing Bariatric Bypass Surgery

Abstract

Nearly 50 % of our patients had either experienced gallstones before LRYGB or developed gallstones after LRYGB. In the group with new gallstone development, 50 % required emergency cholecystectomy. These results, together with the reported better quality of life after a combined procedure and the reported economic benefits, support the use of concomitant prophylactic cholecystectomy in patients undergoing LRYGB.

A Prospective Study of the Conservative Management of Asymptomatic Preoperative and Postoperative Gallbladder Disease in Bariatric Surgery

“…Because there is no clear consensus about the best management, various options have been proposed over the last decades [11,12]. Several studies have assessed the advantages and disadvantages of concomitant gallbladder removal during the bariatric procedure [13][14][15][16][17][18][19][20]. Among the advantages observed are that morbidity is not increased, the procedure is safer and cheaper with just an extra 30 min of operation time and no additional hospital stay, a minimal complication rate, and an improved quality of life [3,[13][14][15][16][17][18].…”

“…Several studies have assessed the advantages and disadvantages of concomitant gallbladder removal during the bariatric procedure [13][14][15][16][17][18][19][20]. Among the advantages observed are that morbidity is not increased, the procedure is safer and cheaper with just an extra 30 min of operation time and no additional hospital stay, a minimal complication rate, and an improved quality of life [3,[13][14][15][16][17][18]. In contrast, a meta-analysis that included 13 studies (>6000 patients) indicated that concomitant cholecystectomy should be generally avoided; rather, it should be performed only in patients with symptomatic gallbladder disease, as bariatric surgery alone had lower complication and mortality rates (0.1 vs. 0.2 %, p = 0.012) than concomitant surgery [20].…”

“…There is a wide variety of treatments previously described, such as Bpreventive^preoperative [11,13], prophylactic concomitant [3,10,11,[13][14][15][16][17][18], or postoperative cholecystectomy [13,19,20]. Other options include medical (ursodeoxycholic acid) and conservative (observational) management [6,10,12,[20][21][22][23][24].…”

Laparoscopy-assisted ERCP (LA-ERCP) following bariatric gastric bypass surgery: initial experience of a single UK centre

“…For this reason, elective cholecystectomy at the time of bariatric surgery is recommended by some centres, but it can be technically challenging, with a higher incidence of complications 6–9. There are many conflicting retrospective case series on this particular topic, with some suggesting that the high rates of gall bladder disease and subsequent need for emergency procedures necessitate performing concomitant gall bladder surgery at index gastric bypass 10 11. However, there is no expert or international consensus on cholecystectomy for this indication.…”

Potential Benefits of Prophylactic Cholecystectomy in Patients Undergoing Bariatric Bypass Surgery

“…Dear Editor, We read with interest the article of Amstutz et al [1] and congratulate the authors for selecting such as a practical and important subject. Basically, gallbladder/gallstone problem is associated with successful weight loss following bariatric surgery.…”