Routine cholecystectomy is not mandatory during morbid obesity surgery

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 underw...

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Veröffentlicht in:Surgery for obesity and related diseases 2007-07, Vol.3 (4), p.456-460
Hauptverfasser: Ellner, Scott J., D.O, Myers, Tamara T., B.S, Piorkowski, James R., M.D, Mavanur, Arun A., M.D, Barba, Carlos A., M.D., F.A.C.S., F.R.C.S
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container_end_page 460
container_issue 4
container_start_page 456
container_title Surgery for obesity and related diseases
container_volume 3
creator Ellner, Scott J., D.O
Myers, Tamara T., B.S
Piorkowski, James R., M.D
Mavanur, Arun A., M.D
Barba, Carlos A., M.D., F.A.C.S., F.R.C.S
description 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.
doi_str_mv 10.1016/j.soard.2006.11.008
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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.</description><identifier>ISSN: 1550-7289</identifier><identifier>EISSN: 1878-7533</identifier><identifier>DOI: 10.1016/j.soard.2006.11.008</identifier><identifier>PMID: 17442623</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>Adult ; Bariatric Surgery ; Cholecystectomy ; Cholecystectomy - utilization ; Cholecystolithiasis - complications ; Cholecystolithiasis - epidemiology ; Cholecystolithiasis - surgery ; Cholelithiasis ; Female ; Gallbladder ; Gastroenterology and Hepatology ; Humans ; Male ; Middle Aged ; Morbid obesity ; Obesity, Morbid - complications ; Obesity, Morbid - surgery ; Retrospective Studies ; Surgery</subject><ispartof>Surgery for obesity and related diseases, 2007-07, Vol.3 (4), p.456-460</ispartof><rights>American Society for Bariatric Surgery</rights><rights>2007 American Society for Bariatric Surgery</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c412t-3619d68430c61fcea375900d2de7c0e94f13c84dea63d6aaa1522fd945fb4e4e3</citedby><cites>FETCH-LOGICAL-c412t-3619d68430c61fcea375900d2de7c0e94f13c84dea63d6aaa1522fd945fb4e4e3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/j.soard.2006.11.008$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,780,784,3550,27924,27925,45995</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/17442623$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Ellner, Scott J., D.O</creatorcontrib><creatorcontrib>Myers, Tamara T., B.S</creatorcontrib><creatorcontrib>Piorkowski, James R., M.D</creatorcontrib><creatorcontrib>Mavanur, Arun A., M.D</creatorcontrib><creatorcontrib>Barba, Carlos A., M.D., F.A.C.S., F.R.C.S</creatorcontrib><title>Routine cholecystectomy is not mandatory during morbid obesity surgery</title><title>Surgery for obesity and related diseases</title><addtitle>Surg Obes Relat Dis</addtitle><description>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.</description><subject>Adult</subject><subject>Bariatric Surgery</subject><subject>Cholecystectomy</subject><subject>Cholecystectomy - utilization</subject><subject>Cholecystolithiasis - complications</subject><subject>Cholecystolithiasis - epidemiology</subject><subject>Cholecystolithiasis - surgery</subject><subject>Cholelithiasis</subject><subject>Female</subject><subject>Gallbladder</subject><subject>Gastroenterology and Hepatology</subject><subject>Humans</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Morbid obesity</subject><subject>Obesity, Morbid - complications</subject><subject>Obesity, Morbid - surgery</subject><subject>Retrospective Studies</subject><subject>Surgery</subject><issn>1550-7289</issn><issn>1878-7533</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2007</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqFkUtr3TAQhUVpadK0vyBQvOrO7uhtL1IIIWkCgUIf0J3QlcapbmwrkeyA_310cy8UuulqZnHOGeY7hJxSaChQ9Xnb5GiTbxiAaihtANpX5Ji2uq215Px12aWEWrO2OyLvct4CcCU1e0uOqBaCKcaPydX3uMxhwsr9iQO6Nc_o5jiuVcjVFOdqtJO3c0xr5ZcUprtqjGkTfBU3mMO8VnlJd5jW9-RNb4eMHw7zhPy6uvx5cV3ffvt6c3F-WztB2VxzRTuvWsHBKdo7tFzLDsAzj9oBdqKn3LXCo1XcK2stlYz1vhOy3wgUyE_Ip33uQ4qPC-bZjCE7HAY7YVyyUS0FqaUuQr4XuhRzTtibhxRGm1ZDwezwma15wWd2-AylpuArro-H-GUzov_rOfAqgrO9AMuTTwGTyS7g5NCHVMAZH8N_Dnz5x--GMAVnh3tcMW_jkqbCz1CTmQHzY9fgrkBQUDLlb_4MUomYFg</recordid><startdate>20070701</startdate><enddate>20070701</enddate><creator>Ellner, Scott J., D.O</creator><creator>Myers, Tamara T., B.S</creator><creator>Piorkowski, James R., M.D</creator><creator>Mavanur, Arun A., M.D</creator><creator>Barba, Carlos A., M.D., F.A.C.S., F.R.C.S</creator><general>Elsevier Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20070701</creationdate><title>Routine cholecystectomy is not mandatory during morbid obesity surgery</title><author>Ellner, Scott J., D.O ; Myers, Tamara T., B.S ; Piorkowski, James R., M.D ; Mavanur, Arun A., M.D ; Barba, Carlos A., M.D., F.A.C.S., F.R.C.S</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c412t-3619d68430c61fcea375900d2de7c0e94f13c84dea63d6aaa1522fd945fb4e4e3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2007</creationdate><topic>Adult</topic><topic>Bariatric Surgery</topic><topic>Cholecystectomy</topic><topic>Cholecystectomy - utilization</topic><topic>Cholecystolithiasis - complications</topic><topic>Cholecystolithiasis - epidemiology</topic><topic>Cholecystolithiasis - surgery</topic><topic>Cholelithiasis</topic><topic>Female</topic><topic>Gallbladder</topic><topic>Gastroenterology and Hepatology</topic><topic>Humans</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Morbid obesity</topic><topic>Obesity, Morbid - complications</topic><topic>Obesity, Morbid - surgery</topic><topic>Retrospective Studies</topic><topic>Surgery</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Ellner, Scott J., D.O</creatorcontrib><creatorcontrib>Myers, Tamara T., B.S</creatorcontrib><creatorcontrib>Piorkowski, James R., M.D</creatorcontrib><creatorcontrib>Mavanur, Arun A., M.D</creatorcontrib><creatorcontrib>Barba, Carlos A., M.D., F.A.C.S., F.R.C.S</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Surgery for obesity and related diseases</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Ellner, Scott J., D.O</au><au>Myers, Tamara T., B.S</au><au>Piorkowski, James R., M.D</au><au>Mavanur, Arun A., M.D</au><au>Barba, Carlos A., M.D., F.A.C.S., F.R.C.S</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Routine cholecystectomy is not mandatory during morbid obesity surgery</atitle><jtitle>Surgery for obesity and related diseases</jtitle><addtitle>Surg Obes Relat Dis</addtitle><date>2007-07-01</date><risdate>2007</risdate><volume>3</volume><issue>4</issue><spage>456</spage><epage>460</epage><pages>456-460</pages><issn>1550-7289</issn><eissn>1878-7533</eissn><abstract>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.</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>17442623</pmid><doi>10.1016/j.soard.2006.11.008</doi><tpages>5</tpages></addata></record>
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subjects Adult
Bariatric Surgery
Cholecystectomy
Cholecystectomy - utilization
Cholecystolithiasis - complications
Cholecystolithiasis - epidemiology
Cholecystolithiasis - surgery
Cholelithiasis
Female
Gallbladder
Gastroenterology and Hepatology
Humans
Male
Middle Aged
Morbid obesity
Obesity, Morbid - complications
Obesity, Morbid - surgery
Retrospective Studies
Surgery
title Routine cholecystectomy is not mandatory during morbid obesity surgery
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