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Association of Biliary Disease and Reflux

Melanie Boyle, Daivyd Palencia, Philip Leggett. Houston Northwest Medical Center

Background:
There are very few studies assessing the relationship between gastroesophageal reflux and biliary disease. This is surprising as they share presenting symptoms as well as risk factors, particularly obesity. Our group previously produced a review of 36 patients in our practice who had undergone some type of reflux procedure. Conclusions showed that the prevalence of gallbladder disease in our severe reflux population is much higher compared to that found in the general population. Our goal of this study is to expand on that data to include a larger sample size to investigate the incidence of biliary disease in our reflux population and decide if this should influence our pre-operative algorithm for anti-reflux surgery patients.

Methods:
We expanded on our previously performed retrospective review of patients that underwent laparoscopic fundoplication for reflux disease. We previously reviewed data from 2015 to 2017. We are now looking at data from 2012 to 2017. Our expected sample size will include approximately 150 patients, 75 of which have currently been reviewed. Our previous study included only 36. The surgery preformed was either a Toupet or Nissen fundoplication, and one underwent a Dor. Demographic data, imaging studies, and pathology results were reviewed.

Results:
We looked at whether each patient who underwent antireflux surgery had a prior cholecystectomy either remotely or recently, underwent concomitant cholecystectomy, or had no biliary disease in their workup. The groups had similar age and were predominantly women.

Conclusion:
We once again demonstrated that the prevalence of gallbladder disease in our severe reflux population is much higher than the general population. When approaching a patient with gastroesophageal reflux disease, attention should be paid to gallbladder symptomatology as well. We recommend that it may be beneficial to include gallbladder ultrasound in pre-operative workup for antireflux surgery so that concomitant cholecystectomy can be performed if indicated.


Presented at the SAGES 2017 Annual Meeting in Houston, TX.

Abstract ID: 87038

Program Number: P091

Presentation Session: iPoster Session (Non CME)

Presentation Type: Poster

37

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