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A 3-Year MBSAQIP propensity-matched analysis of Roux-en-Y gastric bypass with concomitant cholecystectomy: Is the robotic or laparoscopic approach preferred?

  • 2020 SAGES Oral
  • Published:
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Abstract

Background

The primary objective of this study was to compare outcomes of patients undergoing minimally invasive RYGB (MIS/RYGB) versus MIS/RYGB with concomitant Cholecystectomy (CCY). A secondary objective was to compare the outcomes for laparoscopic RYGB (LRYGB) and robotic RYGB (RRYGB) with concomitant CCY.

Methods

Outcomes of 117,939 MIS/RYGB with and without CCY were propensity-matched (Age, Gender, BMI, Comorbidities), 10:1, using the Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program (MBSAQIP) database from 2015–2017. The MIS/RYGB with CCY were then separated into LRYGB and RRYGB cases for comparison. Exclusion criteria included emergency cases, conversions to open, and age less than 18.

Results

The operative time and length of stay (LOS) was significantly increased with addition of concomitant CCY. There was no significant difference in readmission, reoperation, intervention, morbidity, or mortality. The RRYGB with CCY approach was associated with a significantly longer operative times compared to the LRYGB with CCY (177 vs. 135 min, p < 0.0001). The laparoscopic and robotic groups demonstrated no significant difference LOS, readmission, reoperation, intervention, morbidity, or mortality rates.

Conclusions

Our study demonstrates that concomitant cholecystectomy increased the operative time and length of stay. However, concomitant CCY was not associated with any increased morbidity. The study demonstrated no significant difference in morbidity between robotic and laparoscopic approach. The robotic approach, however, was associated with a significantly longer operative time compared to the laparoscopic approach. While the indications for CCY remain controversial, concomitant CCY does not convey additional risk regardless of operative approach.

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Authors and Affiliations

  1. Geisinger Medical Center, 100 N Academy Drive, Danville, PA, 17822, USA

    Alexandra M. Falvo, Voranaddha Vacharathit, James Dove, Marcus Fluck, Mustapha Daouadi, Jon Gabrielsen, Anthony Petrick & David M. Parker

  2. Geisinger Commonwealth Medical Center, Scranton, USA

    Ryan Horsley

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  1. Alexandra M. Falvo
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  2. Voranaddha Vacharathit
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  3. James Dove
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Correspondence to David M. Parker.

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Drs Falvo, Vacharathit, Daouadi, Gabrielsen, Horsley, Petrick and Parker, and Mr. Dove and Fluck have nothing to disclose.

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Falvo, A.M., Vacharathit, V., Dove, J. et al. A 3-Year MBSAQIP propensity-matched analysis of Roux-en-Y gastric bypass with concomitant cholecystectomy: Is the robotic or laparoscopic approach preferred?. Surg Endosc 35, 4712–4718 (2021). https://doi.org/10.1007/s00464-020-07939-0

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  • DOI: https://doi.org/10.1007/s00464-020-07939-0

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