Should Cholecystectomy be Performed Simultaneously with Bariatric Surgery in Obesity Patients?

Öz

Introduction: Asymptomatic cholelithiasis may be detected in the tests performed while obese patients are being prepared for surgery. Determining whether asymptomatic gallstones will cause enough symptoms after bariatric surgery to cause the patient to undergo cholecystectomy surgery will help in the decision to perform concomitant cholecystectomy. This study aimed to determine whether there is a marker to determine whether patients with preoperative cholelithiasis are likely to undergo cholecystectomy after bariatric surgery. Material and Methods: We retrospectively reviewed the files of 771 patients who underwent bariatric surgery for obesity in the Gastroenterology Surgery Clinic of a Tertiary Training and Research Hospital between January 2015 and November 2023. Patients with cholelithiasis before bariatric surgery were included in Group 1 if they had undergone cholecystectomy surgery after bariatric surgery and in Group 2 if they had not. Results: Cholelithiasis was detected in 168 (21.8%) of 771 patients whose charts were reviewed. Group 1 included 73 patients who had undergone cholecystectomy after bariatric surgery, and Group 2 included 90 patients who had not undergone cholecystectomy. There were significant differences between the two groups in terms of age, gender, height-weight ratio, hemoglobin, total cholesterol, low and high-density lipoprotein, triglycerides, gallbladder stone diameter (p=0.395, 0.828, 0.584, 0.660, 0.316, 0.461, 0.988, 0.476, 0.208, respectively). Discussions: Our study found that asymptomatic gallstones required surgery twice as often as in the general population. Age, gender, height-weight ratio, hemoglobin, total cholesterol, low and high-density lipoprotein, triglycerides, and gallbladder stone diameter did not affect asymptomatic gallstones becoming symptomatic to require surgery. Obese patients undergo cholecystectomy surgery after bariatric surgery at a much higher rate than the general population. Therefore, cholecystectomy simultaneously with bariatric surgery should be considered as an option in these patients.

Anahtar Kelimeler

• bariatric surgery
• cholecystectomy
• obesity

Kaynakça

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