Laparoscopic sleeve gastrectomy and simultaneous cholecystectomy: a choice of optimal tactics
DOI:
https://doi.org/10.14739/2310-1210.2022.2.243597Keywords:
obesity, cholelithiasis, laparoscopy, gastrectomy, cholecystectomyAbstract
Obesity has become a worldwide pandemic that has led to an increase in morbidity and mortality in patients, both young and old. Conservative treatments for obesity did not live up to expectations. Bariatric surgery has been proven to be a safe and effective treatment for obesity with weight reduction, resolution of obesity-related comorbidities, improved quality of life and an increased life expectancy.
Laparoscopic sleeve gastrectomy (LSG) has become the most popular bariatric procedure worldwide. Whether to perform simultaneous cholecystectomy (CHE) during bariatric surgery is a subject of debate among bariatric surgeons.
The aim of the study was to form an optimal tactics regarding the expediency of performing simultaneous CHE in LSG in patients with obesity.
Materials and methods. Between January 2012 and March 2021, 59 morbidly obese patients underwent LSG and were considered for the present study. The patients were subdivided in the first group undergoing LSG (n = 39) and the second group undergoing LSG with simultaneous CHE (n = 20). Demographics of both groups were similar.
Results. The mean BMI in the first group was 51.9 ± 7.6 kg/m2 with no significant difference compared to the second group values 48.7 ± 7.1 kg/m2 (P = 0.117). There was no significant difference in pain syndrome level and postoperative in-patient treatment duration (P = 0.236 and P = 0.983, respectively) in the groups.
Assuming equal intraoperative tactics and approaches to patient management after LSG, the simultaneously performed CHE resulted in significant prolongation of surgical intervention time (P = 0.0001). The postoperative complication rate in the second group was slightly higher than that in the first group, but it did not reach the statistical significance (P = 0.198). No significant difference in the fatality rate was detected in the study groups (P = 0.16).
Conclusions. Simultaneous CHE during LSG is safe and warranted when indicated in gallstone disease. Simultaneous CHE during LSG is still debatable.
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