Prophylactic Cholecystectomy, a Mandatory Step in Morbidly Obese Patients Undergoing Laparoscopic Roux-en-Y Gastric Bypass
Journal of Gastrointestinal Surgery, 07/19/2011
D’Hondt M et al. – Symptomatic gallstone disease occurred only in 6.9% of patients post–laparoscopic Roux–en–Y gastric bypass (LRYGBP). Multivariate analysis identified weight loss at 3 months post–LRYGBP of more than 50% of excess weight as the sole significant independent predictor of delayed symptomatic cholecystolithiasis. Prophylactic cholecystectomy (CCE) should not be recommended at the time of LRYGBP.
Between August 2003 and November 2009, 724 patients underwent LRYGBP at the Groeninge Hospital.
Preoperative ultrasound was performed in 600 of 641 patients without history of CCE and 120 (20.0%) were diagnosed with cholecystolithiasis.
625 patients were included, 43(6.9%) developed delayed symptoms related to biliary disease.
Of these 43 patients, 39 underwent post-LRYGBP CCE.
Of these 39 patients, 9 (7.5%) had a positive ultrasound prior to LRYGBP.
Multivariate analysis identified weight loss at 3 months post-LRYGB of more than 50% of excess weight [HR (95% CI), 2.04 (1.04–4.28); p=0.037) as the sole significant independent predictor of delayed symptomatic cholecystolithiasis.
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