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Is Concomitant Cholecystectomy Necessary for Asymptomatic Cholelithiasis During Laparoscopic Sleeve Gastrectomy?

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Abstract

Background

There is not any consensus on concomitant cholecystectomy for asymptomatic gallbladder stones during laparoscopic sleeve gastrectomy (LSG). The aim of this study was to evaluate the surveillance results of the LSG patients who have asymptomatic gallbladder stones and did not undergo cholecystectomy.

Methods

Patients who underwent laparoscopic sleeve gastrectomy with preoperatively detected gallbladder stones and completed at least 6 months follow-up were included in the study. Concomitant cholecystectomy was performed for symptomatic patients while it was not performed for asymptomatic subjects. At the end of the follow-up time, symptoms and signs related to gallbladder disease were recorded. Clinical and demographic characteristics were compared between symptomatic and asymptomatic patients.

Results

Between February 2012 and October 2016, 312 laparoscopic sleeve gastrectomies were performed. Among the patients, 24 were regarded as asymptomatic cholelithiasis, and cholecystectomy was not performed. The mean follow-up period was 27 (6–58) months. The mean preoperative BMI was 50.0 ± 7.6 kg/m2, and at the end of the follow-up time, it decreased to 35.6 ± 8.8 kg/m2. Five (20.8%) patients experienced biliary colic. Acute cholecystitis or obstructive jaundice was not observed in any of the patients. Characteristics of patients who developed symptomatic gallbladder disease (n = 5) were not significantly different from those of patients who remained asymptomatic (n = 19).

Conclusions

The risk of becoming symptomatic for asymptomatic cholelithiasis is very close to the healthy population after sleeve gastrectomy. Although further studies with a high number of cases are needed, we suggest only observation for asymptomatic gallbladder stones in patients who will undergo sleeve gastrectomy.

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Acknowledgements

This research received no specific grant from any funding agency in the public, commercial, or not-for-profit sectors.

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Authors and Affiliations

  1. Department of General Surgery, Marmara University Pendik Education and Research Hospital, Istanbul, Turkey

    Samet Yardimci, Mumin Coskun, Salih Demircioglu & Aylin Erdim

  2. Genel Cerrahi Klinigi, Marmara Universitesi Pendik EAH, Fevzi Cakmak Mah. Muhsin Yazıcıoglu cad. No:10 Ust Kaynarca, Pendik, Istanbul, Turkey

    Samet Yardimci

  3. Department of General Surgery, Acibadem Altunizade Hospital, Istanbul, Turkey

    Asim Cingi

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  1. Samet Yardimci
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Correspondence to Samet Yardimci.

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The authors declare that they have no conflict of interest.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institution and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

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Informed consent was obtained for all individual participants included in the study.

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Yardimci, S., Coskun, M., Demircioglu, S. et al. Is Concomitant Cholecystectomy Necessary for Asymptomatic Cholelithiasis During Laparoscopic Sleeve Gastrectomy?. OBES SURG 28, 469–473 (2018). https://doi.org/10.1007/s11695-017-2867-3

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  • DOI: https://doi.org/10.1007/s11695-017-2867-3

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