TITLE

Gallbladder Management During Laparoscopic Roux-en-Y Gastric Bypass Surgery: Routine Preoperative Screening for Gallstones and Postoperative Prophylactic Medical Treatment are Not Necessary

AUTHOR(S)
Patel, Kevin R.; White, S. C.; Tejirian, Talar; Han, Soo H.; Russell, Doug; Vira, Darshai; Liao, Lingchen; Patel, Karina B.; Gracia, Carlos; Haigh, Phillip; Dutson, Erik; Mehran, Amir
PUB. DATE
October 2006
SOURCE
American Surgeon;Oct2006, Vol. 72 Issue 10, p857
SOURCE TYPE
Academic Journal
DOC. TYPE
Article
ABSTRACT
In the bariatric surgery literature, the optimum approach to the gallbladder is controversial. Recommendations range from concomitant cholecystectomy to selective screening and postoperative medical prophylaxis. At our institution, we have taken a highly selective approach where patients are not routinely screened for gallstones, nor are they medically treated postoperatively with bile salts. We have reviewed our experience with this approach. From January 2003 to January 2005, 407 laparoscopic Roux en Y gastric bypasses were performed at UCLA and postoperative outcomes were collected into a prospective database. Exclusion criteria included previous cholecystectomy, a follow-up period less than 6 months, or incomplete records. One hundred ninety-nine patients were included in the study. With a mean follow up period of 17.8 months, 12 (6%) patients required cholecystectomy for gallstone-induced pathology. Laparoscopic removal was performed in 11 (92%) patients. Indications for surgery included acute cholecystitis in five (2.5%) patients, gallstone pancreatitis in two (1%) patients, and biliary colic alone in another five (2.5%) patients. The incidence of symptomatic gallstones requiring cholecystectomy after laparoscopic Roux en Y gastric bypass is low. These results are similar to those from institutions where routine preoperative screening and prophylactic postoperative medical therapy is used. Routine preoperative screening or medical prophylaxis may not be necessary.
ACCESSION #
22667461

 

Related Articles

  • Letter to the editors. Hall, Robert C. // Surgical Endoscopy;Dec2013, Vol. 27 Issue 12, p4747 

    A letter to the editor is presented in response to the article "Laparoscopic Cholecystectomy: First Do Not Harm: Second, Take Care of Bile Duct Stones," by G. Berci et al. in a 2013 issue.

  • Predicting Difficult Laparoscopic Cholecystectomy Based on Clinicoradiological Assessment. NIDONI, RAVINDRA; UDACHAN, TEJASWINI V.; SASNUR, PRASAD; BALOORKAR, RAMAKANTH; SINDGIKAR, VIKRAM; NARASANGI, BASAVARAJ // Journal of Clinical & Diagnostic Research;Dec2015, Vol. 9 Issue 12, p9 

    Introduction: Laparoscopic cholecystectomy (LC) is the gold standard treatment for symptomatic cholelithiasis. However, of all Laparoscopic cholecystectomies, 1-13% requires conversion to an open for various reasons. Thus, for surgeons it would be helpful to establish criteria that would predict...

  • Follow-Up After Bile Duct Sphincterotomy. Walling, Anne D. // American Family Physician;1/15/2003, Vol. 67 Issue 2, p397 

    Discusses the study 'Wait-and-See Policy or Laparoscopic Cholecystectomy After Endoscopic Sphincterotomy for Bile-Duct Stones: A Randomised Trial,' by D. Boerma et al., from the September 7, 2002 issue of 'The Lancet.'

  • Concomitant Cholecystectomy During Laparoscopic Roux-en-Y Gastric Bypass in Obese Patients Is Not Justified: A Meta-Analysis. Warschkow, Rene; Tarantino, Ignazio; Ukegjini, Kristjan; Beutner, Ulrich; Güller, Ulrich; Schmied, Bruno; Müller, Sascha; Schultes, Bernd; Thurnheer, Martin // Obesity Surgery;Mar2013, Vol. 23 Issue 3, p397 

    While LRYGB has become a cornerstone in the surgical treatment of morbidly obese patients, concomitant cholecystectomy during LRYGB remains a matter of debate. The aim of this meta-analysis was to estimate the rate and morbidity of subsequent cholecystectomy after laparoscopic Roux-en-Y gastric...

  • Trends in Use of Upper Abdominal Procedures in Sweden 1998-2011: A Population-Based Study. Sundbom, Magnus; Hedberg, Jakob // World Journal of Surgery;Jan2014, Vol. 38 Issue 1, p33 

    Background: Surgical care is constantly developing as demographic shifts occur and indications change when new techniques are introduced. The purpose of this study was to describe trends of in-hospital upper abdominal procedures in Sweden during 1998-2011. Methods: Data were collected from the...

  • Symptoms Before and After Laparoscopic Cholecystectomy for Gallstones. Lublin, Matthew; Crawford, David L.; Hiatt, Jonathan R.; Phillips, Edward H. // American Surgeon;Oct2004, Vol. 70 Issue 10, p863 

    Between 1989 and 1995, 1380 patients underwent laparoscopic cholecystectomy for symptomatic cholelithiasis by a single surgical group at a large private teaching hospital. Thirteen hundred surveys were mailed, and 573 (44.3%) were completed at least 6 months postoperatively. Pain and nonpain...

  • Subcapsular hematoma of the liver after laparoscopic cholecystectomy. Shetty, Geeta S.; Falconer, J. Stuart; Benyounes, Hakim // Journal of Laparoendoscopic & Advanced Surgical Techniques;Feb2005, Vol. 15 Issue 1, p48 

    Two female patients underwent an uneventful laparoscopic chloecystectomy (LC) for cholelithiasis. Their past medical history was insignificant. The first patient had diclofenac sodium for her postoperative pain relief. Both patients returned in the early postoperative period with pain in the...

  • Gastric Distension During Laparoscopic Cholecystectomy: Comparison between ETT and PLMA. Chakraborty, Arpan; Kumar, G. Praveen; Bhattacharya, Prithwis // Internet Journal of Anesthesiology;2007, Vol. 13 Issue 2, p32 

    Gastric distension during laparoscopic cholecystectomy can lead to serious injury to the stomach during insertion of trocar. The incident of gastric distension was found lower in patients with ProSeal LMA than with endotracheal intubation.

  • Cosmetic Laparoscopic Cholecystectomy. C̆ala, Zoran; Niks̆ić, Krunoslav; Nesek-Adam, Vis̆nja; Klapan, Denis; Soldo, Ivo // Journal of Laparoendoscopic & Advanced Surgical Techniques;Dec2006, Vol. 16 Issue 6, p577 

    Background: The cosmetic outcome and recovery time of laparoscopic cholecystectomy has been improved by modifying the operation technique and reducing the number and size of trocars. The next step to improve cosmetic results is moving two trocars below the pubic hairline. We describe our...

Share

Read the Article

Courtesy of THE LIBRARY OF VIRGINIA

Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics