Routine cholecystectomy is not mandatory during morbid obesity surgery

Scott J. Ellner, Tamara T. Myers, James R. Piorkowski, Arun Mavanur, Carlos A. Barba

Research output: Contribution to journalArticle

Abstract

Background: Controversy exists concerning the utility of routine cholecystectomy during bariatric surgery. We report our series of bariatric surgical procedures at our institution without concurrent cholecystectomy. Methods: From October 2003 to August 2005, 621 morbidly obese patients underwent a weight loss operation. Preoperatively, each patient had undergone abdominal ultrasound (AUS) to evaluate for abnormal gallbladder findings. Patients with previous cholecystectomy were excluded. Symptomatic patients with AUS findings consistent with gallbladder disease underwent concomitant cholecystectomy and bariatric surgery. Asymptomatic patients, despite AUS findings, did not undergo cholecystectomy with their bariatric operation. A comparison between the preoperative AUS-positive and AUS-negative, asymptomatic patients after bariatric surgery was performed. Results: Of the 621 patients who underwent bariatric surgery, 170 (27%) had undergone previous cholecystectomy and were excluded. Of the remaining 451 patients, 17 with positive AUS findings and symptoms underwent cholecystectomy during bariatric surgery. The range of follow-up was 4-25 months. Of the 451 patients, 324 were asymptomatic and had negative AUS findings and 102 were asymptomatic and had positive AUS findings for gallbladder abnormalities. Postoperatively, 29 asymptomatic/AUS-negative patients (9%) developed symptoms and had positive AUS findings. Nine asymptomatic patients with AUS positive findings (9%) developed symptoms. Finally, 38 patients (8.4%) went on to undergo elective cholecystectomy. These 2 groups were not signficantly different statistically. Conclusions: In this study, the development of symptomatic/AUS-positive gallbladder abnormalities was low after obesity surgery, suggesting that mandatory cholecystectomy is not required at bariatric surgery.

Original languageEnglish (US)
Pages (from-to)456-460
Number of pages5
JournalSurgery for Obesity and Related Diseases
Volume3
Issue number4
DOIs
StatePublished - Jul 1 2007
Externally publishedYes

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Morbid Obesity
Cholecystectomy
Bariatric Surgery
Gallbladder
Gallbladder Diseases
Bariatrics
Weight Loss
Obesity

Keywords

  • Bariatric surgery
  • Cholecystectomy
  • Cholelithiasis
  • Gallbladder
  • Morbid obesity

ASJC Scopus subject areas

  • Surgery

Cite this

Routine cholecystectomy is not mandatory during morbid obesity surgery. / Ellner, Scott J.; Myers, Tamara T.; Piorkowski, James R.; Mavanur, Arun; Barba, Carlos A.

In: Surgery for Obesity and Related Diseases, Vol. 3, No. 4, 01.07.2007, p. 456-460.

Research output: Contribution to journalArticle

Ellner, Scott J. ; Myers, Tamara T. ; Piorkowski, James R. ; Mavanur, Arun ; Barba, Carlos A. / Routine cholecystectomy is not mandatory during morbid obesity surgery. In: Surgery for Obesity and Related Diseases. 2007 ; Vol. 3, No. 4. pp. 456-460.
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abstract = "Background: Controversy exists concerning the utility of routine cholecystectomy during bariatric surgery. We report our series of bariatric surgical procedures at our institution without concurrent cholecystectomy. Methods: From October 2003 to August 2005, 621 morbidly obese patients underwent a weight loss operation. Preoperatively, each patient had undergone abdominal ultrasound (AUS) to evaluate for abnormal gallbladder findings. Patients with previous cholecystectomy were excluded. Symptomatic patients with AUS findings consistent with gallbladder disease underwent concomitant cholecystectomy and bariatric surgery. Asymptomatic patients, despite AUS findings, did not undergo cholecystectomy with their bariatric operation. A comparison between the preoperative AUS-positive and AUS-negative, asymptomatic patients after bariatric surgery was performed. Results: Of the 621 patients who underwent bariatric surgery, 170 (27{\%}) had undergone previous cholecystectomy and were excluded. Of the remaining 451 patients, 17 with positive AUS findings and symptoms underwent cholecystectomy during bariatric surgery. The range of follow-up was 4-25 months. Of the 451 patients, 324 were asymptomatic and had negative AUS findings and 102 were asymptomatic and had positive AUS findings for gallbladder abnormalities. Postoperatively, 29 asymptomatic/AUS-negative patients (9{\%}) developed symptoms and had positive AUS findings. Nine asymptomatic patients with AUS positive findings (9{\%}) developed symptoms. Finally, 38 patients (8.4{\%}) went on to undergo elective cholecystectomy. These 2 groups were not signficantly different statistically. Conclusions: In this study, the development of symptomatic/AUS-positive gallbladder abnormalities was low after obesity surgery, suggesting that mandatory cholecystectomy is not required at bariatric surgery.",
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AB - Background: Controversy exists concerning the utility of routine cholecystectomy during bariatric surgery. We report our series of bariatric surgical procedures at our institution without concurrent cholecystectomy. Methods: From October 2003 to August 2005, 621 morbidly obese patients underwent a weight loss operation. Preoperatively, each patient had undergone abdominal ultrasound (AUS) to evaluate for abnormal gallbladder findings. Patients with previous cholecystectomy were excluded. Symptomatic patients with AUS findings consistent with gallbladder disease underwent concomitant cholecystectomy and bariatric surgery. Asymptomatic patients, despite AUS findings, did not undergo cholecystectomy with their bariatric operation. A comparison between the preoperative AUS-positive and AUS-negative, asymptomatic patients after bariatric surgery was performed. Results: Of the 621 patients who underwent bariatric surgery, 170 (27%) had undergone previous cholecystectomy and were excluded. Of the remaining 451 patients, 17 with positive AUS findings and symptoms underwent cholecystectomy during bariatric surgery. The range of follow-up was 4-25 months. Of the 451 patients, 324 were asymptomatic and had negative AUS findings and 102 were asymptomatic and had positive AUS findings for gallbladder abnormalities. Postoperatively, 29 asymptomatic/AUS-negative patients (9%) developed symptoms and had positive AUS findings. Nine asymptomatic patients with AUS positive findings (9%) developed symptoms. Finally, 38 patients (8.4%) went on to undergo elective cholecystectomy. These 2 groups were not signficantly different statistically. Conclusions: In this study, the development of symptomatic/AUS-positive gallbladder abnormalities was low after obesity surgery, suggesting that mandatory cholecystectomy is not required at bariatric surgery.

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