Robert M Cunningham, MD, Jason E Kuhn, DO, Marcus Fluck, James T Dove, Katherine T Jones, Ryan D Horsley, MD, Jon D Gabrielsen, MD, Anthony T Petrick, MD, David M Parker, MD. Geisinger
Introduction: The aim of the study was to evaluate outcomes of selective concurrent cholecystectomy and long term biliary outcomes after Roux-en-Y Gastric Bypass (RYGB).
Methods: We performed a retrospective analysis of patients who underwent Laparoscopic RYGB (LRYGB) between 2008 and 2018. Chi-square, Fisher’s exact, or Wilcoxon rank-sum tests were used to compare outcomes.
Results: 3004 patients underwent a RYGB (LRYGB n= 2453, open RYGB n= 533). At time of review, 54.7% (n= 1643) of patients had undergone a cholecystectomy. 31.1% of patients (n=933) had a cholecystectomy prior to RYGB, 16.9% (n=509) had a concurrent cholecystectomy and 51.9% (n= 1562) did not have a cholecystectomy. After LRYGB, 12.9% (n=202) underwent an interval cholecystectomy. Of those who underwent LRYGB, 29.9% (n=735) had a prior cholecystectomy. Those who underwent concurrent cholecystectomy/ LRYGB (n=328) were compared with LRYGB alone (n=1231). The concurrent cholecystectomy group were significantly older, higher percentage of females, higher preoperative BMI, higher Charlson Comorbidity index and a higher medication count. The two groups demonstrated no significant difference in BMI nadir, length of stay, complications or mortality.
Conclusions: The study supports that a higher percentage of bariatric patients will undergo cholecystectomy. Long-term follow-up demonstrates a higher rate of interval cholecystectomy than previously reported. Concurrent cholecystectomy can be performed safely without an increase in length of stay, complications or 30-day mortality.
|Laparoscopic RYGB versus combined RYGB/cholecystectomy|
|LRYGB only||Concurrent cholecystectomy|
|%BMI Change, nadir||-33.3||-34.6||0.117|
|Length of stay, days||1.7(1.2)||1.8(1.1)||0.116|
|Readmission, 30 Day||126(10.2)||43(13.1)||0.1368|
|Mortality, 30 Day||1(0.1)||1(0.3)||0.377|
Presented at the SAGES 2017 Annual Meeting in Houston, TX.
Abstract ID: 94441
Program Number: P069
Presentation Session: Poster Session (Non CME)
Presentation Type: Poster