Is concomitant cholecystectomy at the time of bariatric surgery justified? a retrospective study

Nowadays, sleeve Gastrectomy (SG) has become a cornerstone in treating morbid obesity, a condition that has turned into one of the most important health concerns worldwide. Nonetheless, gallbladder (GB) disease remains a frequently seen problem after weight loss. The performance of concomitant cholecystectomy with SG (SCC) is yet still controversial. The study's aim is to assess the safety of performing SCC, the operative time, length of hospital stay (LOS) and the postoperative complications. This is a retrospective case-control study, conducted in Lebanon, comparing patients treated with SG, as control group A, to patients who underwent SCC (group B). Out of 120 patients included in the study, 100 underwent SG and 20 underwent SCC. Those who underwent SCC had an abnormal abdominal ultrasound (US) preoperatively. Out of the patients who had a SG, 40 patients (13.7%) underwent a subsequent cholecystectomy due to GB disease. Eight out of 40 patients (20%) suffered from complications, mainly related to common bile duct stone migration, requiring endoscopic retrograde cholangiopancreatography (ERCP). The mean time until presentation for cholelithiasis post bariatric surgery was 13.03 (±10.01) months and the mean weight loss achieved was 29.9 (±8.8) Kilograms. The mean operative time was increased by 29.9 min (min) for SCC (146.7 min) compared to SG alone (116.8 min). Our study results showed that the incidence of symptomatic GB disease post bariatric surgery (BS) was relatively high and cholecystectomy at that time was not straightforward. Also, SCC performance was highly dependent on the result of the preoperative US.