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Cholecystectomy in Patients Submitted to Bariatric Procedure: A Systematic Review and Meta-analysis

  • Francisco Tustumi
  • Wanderley M. Bernardo
  • Marco A. Santo
  • Ivan Cecconello
Review Article

Abstract

Weight loss following bariatric surgery increases risk for biliary stones. This study performed a meta-analysis evaluating cholecystectomy risks in bariatric patients. A systematic review and meta-analysis were performed. We evaluated the incidence rate for biliary complications in patients followed after bariatric surgery. We compared the risks for mortality, complications, and in hospital stay among patient submitted to cholecystectomy before, concomitantly with or after bariatric surgery, as well as patients submitted to bariatric surgery and cholecystectomy, and patients submitted only to bariatric surgery in order to evaluate when to perform cholecystectomy in morbidly obese patients. The incidence rate of biliary complications was 5.54 cases/1000 patient year. The addition of cholecystectomy to bariatric surgery resulted in an increased risk for complications (RD = 0.02). The risk for complications (RD = − 0.09) and reoperation (RD = − 0.02) was lower when performed concomitantly with bariatric surgery compared to post-bariatric procedure. Prophylactic cholecystectomy may be avoided. Patients submitted to bariatric surgery have low incidence rate of biliary complications, and concomitant cholecystectomy increases the risk for postoperative complications and operative time. If cholecystectomy is not indicated, patients should be carefully followed with attention for biliary complications, once cholecystectomy performed post-bariatric surgery is at higher risk for complications and reoperations.

Keywords

Meta-analysis Obesity Cholelithiasis Weight loss Bariatric surgery Gastric bypass 

Notes

Compliance with Ethical Standards

Conflict of Interest

The authors declare that they have no conflict of interest.

Ethical Approval Statement

This article does not contain any studies with human participants or animals performed by any of the authors. The institutional ethics committee approved this study protocol.

Informed Consent Statement

Does not apply.

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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Hospital das Clínicas, Gastroenterology DepartmentUniversity of Sao PauloCerqueira CesarBrazil

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