Safety of concomitant cholecystectomy at the time of laparoscopic sleeve gastrectomy: analysis of the American College of Surgeons National Surgical Quality Improvement Program database
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Elsevier Inc.
Abstract
Background The indication and safety of concomitant cholecystectomy (CC) during bariatric surgical procedures are topics of controversy. Studies on the outcomes of CC with laparoscopic sleeve gastrectomy (LSG) are scarce. Objectives To assess the safety and 30-day surgical outcomes of CC with LSG. Methods A retrospective analysis of the American College of Surgeons National Surgical Quality Improvement Program database 2010 to 2013. Univariate and multivariate analyses were used. Results Between 2010 and 2013, 21,137 patients underwent LSG; of those 422 (2.0%) underwent CC (LSG+CC), and the majority (20,715 [98%]) underwent LSG alone. Patients in both groups were similar in age, sex distribution, baseline weight, and body mass index. The average surgical time was significantly higher, by 33 minutes, in the LSG+CC cohort. No differences were noted between the groups with regard to overall 30-day mortality and length of hospital stay. CC increased the odds of any adverse event (5.7% versus 4.0%), but the difference did not reach statistical significance (odds ratio 1.49, P =.07). Two complications were noted to be significantly higher with LSG+CC, namely bleeding (P =.04) and pneumonia (P =.02). Conclusion CC during LSG appears to be a safe procedure with slightly increased risk of bleeding and pneumonia compared with LSG alone. When factoring the potential risk and cost of further hospitalization for deferred cholecystectomy, these data support CC for established gallbladder disease. © 2017 American Society for Metabolic and Bariatric Surgery
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American college of surgeons national surgical quality improvement program, Bariatric surgery, Cholecystectomy, Gallstones, Laparoscopic sleeve gastrectomy, Adult, Aged, Blood loss, surgical, Cholecystectomy, laparoscopic, Combined modality therapy, Female, Gallbladder diseases, Gastrectomy, Humans, Laparoscopy, Length of stay, Male, Middle aged, Obesity, morbid, Operative time, Pneumonia, Postoperative complications, Registries, Retrospective studies, Risk factors, Albumin, Creatinine, Adverse outcome, Albumin blood level, Article, Bleeding disorder, Blood transfusion, Body mass, Clinical outcome, Creatinine blood level, Diabetes mellitus, Dyspnea, Functional status, Gallbladder disease, Heart disease, Human, Laparoscopic cholecystectomy, Major clinical study, Morbidity, Obesity, Operation duration, Operative blood loss, Patient safety, Postoperative complication, Priority journal, Retrospective study, Risk assessment, Surgical mortality, Clinical trial, Complication, Evaluation study, Morbid obesity, Multicenter study, Multimodality cancer therapy, Procedures, Register, Risk factor, Statistics and numerical data