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Obesity Surgery

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01-01-2021 | Bariatric Surgery | Original Contributions

Is It Safe to Recommend Cholecystectomy Whenever Gallstones Develop After Bariatric Surgery?

Authors: Rachid Nagem, Luiz Ronaldo Alberti, Luiz Felipe de Campos-Lobato

Published in: Obesity Surgery | Issue 1/2021

Abstract

Background

Cholelithiasis (ChL) is common after bariatric surgery (BS). Laparoscopic cholecystectomy (LC), the preferential treatment, is usually recommended only to symptomatic patients. LC may be, however, beneficial to asymptomatic patients as well. A prerequisite to such a policy is that it must be safe. This study aimed to assess whether, in post-bariatric (Post-Bar) patients who develop gallstones, LC achieves the same results as those reported in the general population.

Methods

A cohort of 376 patients undergoing elective LC had their medical records reviewed. Patients were divided into non-bariatric (Non-Bar) and Post-Bar groups, and then compared for characteristics and surgical outcomes.

Results

The study included 367 patients, 292 Non-Bar and 75 Post-Bar. Considering characteristics, Post-Bar patients were younger (44.5 ± 11.8 vs 48.4 ± 14.1) and less symptomatic (2.4% vs 19.8%) and had a higher BMI (32.2 ± 4.8 vs 30.8 ± 4.4) than Non-Bar patients. Regarding surgical outcomes, mortality (none), morbidity (1%, only in Non-Bar patients), readmission (1%, only in Non-Bar patients), conversion to laparotomy (0.6%, only in Non-Bar patients) showed no difference between the groups. Operative time (42.6 ± 14.4 min in Non-Bar and 38.2 ± 12.6 min in Post-Bar patients) tended to be lower in Post-Bar patients, p = 0.054. Same-day discharge was higher in Post-Bar patients (98.6%) than in Non-Bar patients (90.4%), p = 0.03.

Conclusions

Compared with Non-Bar patients, LC in Post-Bar patients showed not only similar morbimortality, readmissions, and conversions but also even a higher same-day discharge rate and a trend to lower operative times.

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Title: Is It Safe to Recommend Cholecystectomy Whenever Gallstones Develop After Bariatric Surgery?
Authors: Rachid Nagem
Luiz Ronaldo Alberti
Luiz Felipe de Campos-Lobato
Publication date: 01-01-2021
Publisher: Springer US
Keywords: Bariatric Surgery
Bariatric Surgery
Cholecystectomy
Cholelithiasis
Published in: Obesity Surgery / Issue 1/2021
Print ISSN: 0960-8923
Electronic ISSN: 1708-0428
DOI: https://doi.org/10.1007/s11695-020-04862-0

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Is It Safe to Recommend Cholecystectomy Whenever Gallstones Develop After Bariatric Surgery?

Abstract

Background

Methods

Results

Conclusions

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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