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Obesity Surgery
Published in: Obesity Surgery 3/2013

01-03-2013 | Review

Concomitant Cholecystectomy During Laparoscopic Roux-en-Y Gastric Bypass in Obese Patients Is Not Justified: A Meta-Analysis

Authors: Rene Warschkow, Ignazio Tarantino, Kristjan Ukegjini, Ulrich Beutner, Ulrich Güller, Bruno M. Schmied, Sascha A. Müller, Bernd Schultes, Martin Thurnheer

Published in: Obesity Surgery | Issue 3/2013

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Abstract

While LRYGB has become a cornerstone in the surgical treatment of morbidly obese patients, concomitant cholecystectomy during LRYGB remains a matter of debate. The aim of this meta-analysis was to estimate the rate and morbidity of subsequent cholecystectomy after laparoscopic Roux-en-Y gastric bypass (LRYGB) in obese patients. A meta-analysis was performed analyzing the rate and morbidity of subsequent cholecystectomy in patients who underwent LRYGB without concomitant cholecystectomy. Thirteen studies met the inclusion criteria. The rate of subsequent cholecystectomy was 6.8 % (95 % CI, 5.0–8.7 %) based on 6,048 obese patients who underwent LRYGB without concomitant cholecystectomy. The rate of subsequent cholecystectomy due to biliary colic or gallbladder dyskinesia was 5.3 %; due to cholecystitis, 1.0 %; choledocholithiasis, 0.2 %; and biliary pancreatitis, 0.2 %. The mortality after subsequent cholecystectomy was 0 % (95 % CI, 0–0.1 %). The surgery-related complication rate after subsequent cholecystectomy was 1.8 % (95 % CI, 0.7–3.4 %) resulting in a risk of 0.1 % (95 % CI, 0.03–0.3 %) to suffer from a cholecystectomy-related complication in patients undergoing LRYGB without concomitant cholecystectomy. A prophylactic concomitant cholecystectomy during LRYGB should be avoided in patients without cholelithiasis and exclusively be performed in patients with symptomatic biliary disease.
Footnotes
1
All proportions throughout the manuscript are results of random effect meta-analysis. Therefore, they may differ from plain numerical proportions.
 
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Metadata
Title
Concomitant Cholecystectomy During Laparoscopic Roux-en-Y Gastric Bypass in Obese Patients Is Not Justified: A Meta-Analysis
Authors
Rene Warschkow
Ignazio Tarantino
Kristjan Ukegjini
Ulrich Beutner
Ulrich Güller
Bruno M. Schmied
Sascha A. Müller
Bernd Schultes
Martin Thurnheer
Publication date
01-03-2013
Publisher
Springer-Verlag
Published in
Obesity Surgery / Issue 3/2013
Print ISSN: 0960-8923
Electronic ISSN: 1708-0428
DOI
https://doi.org/10.1007/s11695-012-0852-4

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