Asymptomatic cholelithiasis in bariatric practice
Vladimir R. Stankevich , Alexander V. Smirnov , Alexandr I. Zlobin , Dmitry N. Panchenkov , Valentin I. Sharobaro , Yury V. Ivanov
Journal of Clinical Practice ›› 2022, Vol. 13 ›› Issue (4) : 17 -26.
Asymptomatic cholelithiasis in bariatric practice
Background: The need for simultaneous cholecystectomy for asymptomatic cholelithiasis in patients undergoing bariatric intervention has not been proven. The experience of managing patients with obesity and concomitant disease — cholelithiasis is presented.
Aim: to determine the indications for simultaneous cholecystectomy and bariatric surgery in the combination of morbid obesity and a asymptomatic cholelithiasis.
Methods: The results of observation of 37 patients with initially asymptomatic cholelithiasis were analyzed: 27 patients underwent bariatric surgery and simultaneous cholecystectomy, and 10 patients underwent only bariatric surgery. The immediate and long-term results of the treatment, the quality of life of patients and the cost of the treatment were assessed.
Results: During 12 months of the follow-up, none of the patients who underwent simultaneous cholecystectomy developed any complications. Of the 10 patients in the observation group, 3 were operated on. Two patients underwent laparoscopic cholecystectomy for acute cholecystitis and one patient was operated on for choledocholithiasis with obstructive jaundice. The greatest improvement in the quality of life was observed in the gastric bypass group with simultaneous cholecystectomy. The treatment cost per patient was lower in that group, too.
Conclusion: In the presence of asymptomatic cholelithiasis in a patient with morbid obesity, bariatric intervention and simultaneous cholecystectomy prevents the development of complications of cholelithiasis and thereby potentially improves the quality of life and reduces the cost of medical care.
cholelithiasis / cholecystitis / simultaneous cholecystectomy / bariatric surgery / cholecystectomy / gastric bypass / sleevе gastrectomy
| [1] |
Смирнов А.В., Станкевич В.Р., Панченков Д.Н., и др. Симультанные операции в бариатрической хирургии // Клиническая практика. 2020. Т. 11, № 4. С. 55–63. [Smirnov AV, Stankevich VR, Panchenkov DN, et al. Simultaneous operations in bariatric surgery. Clinical practice. 2020;11(4):55–63. (In Russ).] doi: 10.17816/clinpract58047 |
| [2] |
Amstutz S, Michel JM, Kopp S, Egger B. Potential benefits of prophylactic cholecystectomy in patients undergoing bariatric bypass surgery. Obes Surg. 2015;25(11):2054–2060. doi: 10.1007/s11695-015-1650-6 |
| [3] |
Doulamis IP, Michalopoulos G, Boikou V, et al. Concomitant cholecystectomy during bariatric surgery: The jury is still out. Am J Surg. 2019;218(2):401–410. doi: 10.1016/j.amjsurg.2019.02.006 |
| [4] |
Leyva-Alvizo A, Arredondo-Saldaña G, Leal-Isla-Flores V, et al. Systematic review of management of gallbladder disease in patients undergoing minimally invasive bariatric surgery. Surg Obes Relat Dis. 2020;16(1):158–164. doi: 10.1016/j.soard.2019.10.016 |
| [5] |
Станкевич В.Р. Хирургическое лечение морбидного ожирения в сочетании с желчнокаменной болезнью: Автореф. дис. ... канд. мед. наук. Москва, 2021. 27 с. [Stankevich VR. Surgical treatment of morbid obesity in combination with cholelithiasis [dissertation abstract]. Moscow; 2021. 27 р. (In Russ).] |
| [6] |
Александрова Е.А., Герри Д.К., Кайнд П., Хабибуллина А.Р. Популяционные показатели качества жизни, связанного со здоровьем по опроснику EQ-5D // Здравоохранение Российской Федерации. 2018. Т. 62, № 6. С. 295–303. [Alexandrova EA, Garry DK, Kand P, Khabibullina AR. Population indicators of health-related quality of life according to the EQ-5D questionnaire. Healthcare Russian Federation. 2018;62(6):295–303. (In Russ).] doi: 10.18821/0044-197X-2018-62-6-295-303 |
| [7] |
Illige M, Meyer A, Kovach F. Surgical treatment for asymptomatic cholelithiasis. Am Fam Physician. 2014;89(6):468–470. |
| [8] |
European Association for the Study of the Liver (EASL). EASL Clinical Practice Guidelines on the prevention, diagnosis and treatment of gallstones. J Hepatol. 2016;65(1):146–181. doi: 10.1016/j.jhep.2016.03.005 |
| [9] |
Tazuma S, Unno M, Igarashi Y, et al. Evidence-based clinical practice guidelines for cholelithiasis 2016. J Gastroenterol. 2017; 2(3):276–300. doi: 10.1007/s00535-016-1289-7 |
| [10] |
Worni M, Guller U, Shah A, et al. Cholecystectomy concomitant with laparoscopic gastric bypass: A trend analysis of the nationwide inpatient sample from 2001 to 2008. Obes Surg. 2012; 22(2):220–229. doi: 10.1007/s11695-011-0575-y |
| [11] |
Pineda O, Maydón HG, Amado M, et al. A prospective study of the conservative management of asymptomatic preoperative and postoperative gallbladder disease in bariatric surgery. Obes Surg. 2017;27(1):148–153. doi: 10.1007/s11695-016-2264-3 |
| [12] |
Penna DA, Lange J, Hilbert J, et al. Ursodeoxycholic acid for 6 months after bariatric surgery is impacting gallstone associated morbidity in patients with preoperative asymptomatic gallstones. Obes Surg. 2019;29(4):1216–1221. doi: 10.1007/s11695-018-03651-0 |
| [13] |
Yardimci S, Coskun M, Demircioglu S, et al. Is Concomitant cholecystectomy necessary for asymptomatic cholelithiasis during laparoscopic sleeve gastrectomy? Obes Surg. 2018; 28(2):469–473. doi: 10.1007/s11695-017-2867-3 |
| [14] |
Cunningham RM, Jones KT, Kuhn JE, et al. Asymptomatic cholelithiasis and bariatric surgery: A comprehensive long-term analysis of the risks of biliary disease in patients undergoing primary Roux-En-Y gastric bypass. Obes Surg. 2021;31(3): 1249–1255. doi: 10.1007/s11695-020-05125-8 |
Eco-Vector
/
| 〈 |
|
〉 |