Original articleIncidence of cholecystectomy after bariatric surgery☆
Section snippets
Methods
The New York State Department of Health and the institutional review board approved this study. The Statewide Planning and Research Collaborative System administrative longitudinal database was used to identify all patients undergoing RYGB, sleeve gastrectomy (SG), and laparoscopic adjustable gastric banding (LAGB) between 2004 and 2010 through the use of the International Classification of Diseases, Ninth Revision (ICD-9) and Current Procedural Terminology (CPT) codes. Patients were identified
Results
During this time period, there were 15,301 LAGB patients, 19,996 RYGB, and 1650 SG who had follow-up data and did not have cholecystectomy at the time of bariatric surgery or before that since 2000. Cholecystectomy was performed at the time of original surgery or before that in 1143 of LAGB patients (7.0%), 2772 in RYGB group (12.2%), and 131 patients in SG group (7.4%). Thus, they were excluded in the mentioned patients above. There were 989 (6.5%) patients who underwent cholecystectomy after
Discussion
It is debatable whether routine cholecystectomy should be performed at the time of the original weight loss procedure. There are no current guidelines for prophylactic cholecystectomy; however, concomitant cholecystectomy is not performed routinely during most primary bariatric procedures. Many are arguing that despite the higher prevalence of gallstones in this patient population, the rate of subsequent cholecystectomy remains low, while concomitant cholecystectomy leads to potentially higher
Conclusion
The rate of cholecystectomy after LAGB, RYGB, and SG was 6.5%, 9.7% and 10.1%, respectively. After accounting for other variables, patients after either LAGB or RYGB were less likely to undergo a subsequent cholecystectomy. In addition, CBD injury had a higher rate of .12% during subsequent cholecystectomy. Patients should be counseled preoperatively about this risk. The risks and benefits of ursodiol or prophylactic cholecystectomy should also be considered.
Disclosures
Dr. Pryor is a speaker for Gore, Ethicon, Medtronic, Merck, and Stryker. She has received research support from Obalon and Baronova. There are no other conflicts of interest or financial disclosures for any of the authors.
Acknowledgments
We acknowledge the biostatistical consultation and biostatistical support provided by the Biostatistical Consulting Core at School of Medicine, Stony Brook University.
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Accepted for an oral presentation at Obesity Week, ASMBS 2017, Washington, D.C.