Safety of sleeve gastrectomy and laparoscopic cholecystectomy in obese people with cholelithiasis

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Created On: 23/05/2022

This multicenter randomized trial was carried out to comprehensively assess the impact of sleeve gastrectomy (SG) + laparoscopic cholecystectomy (LC) versus delayed LC after SG in obese people suffering from asymptomatic cholelithiasis.

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Key take away

Concomitant laparoscopic cholecystectomy with sleeve gastrectomy is practical and safe in obese patients with gallbladder stones.

Background

Method

Overall, 222 participants with asymptomatic gallbladder stones were segregated into SG along with LC arm and SG-only arm. The incidence and risk factors of symptomatic gall stones in SG cases with no concomitant LC were also explored.

Result

No statistically significant difference was observed between the LSG + LC arm and SG arm except for postoperative hospital stay and operative time. LC added 40.7 min to SG in SG + LC arm, conversion was required by 3 patients, and early postoperative complications took place in nine cases. The most common gallstone symptom reported was acute cholecystitis.

The most complicated cases (52/61, 85%) eventuated in first-year follow-up. The operative time in the delayed LC arm (n=61) was 50.13 ± 1.99 min. Open conversion occurred in two cases, early postoperative complications took place in 4 patients and postoperative re-intervention was because of cystic artery bleeding and bile leaks.

Conclusion

SG+LC extended the hospital stay and operative time. A decline in the need for a second surgery was seen with LC+SG. The perioperative complications were the same as delayed LC. Concomitant LC with SG was safe.