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Morbidity of cholecystectomy and gastric bypass in a national database
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2018 (English)In: British Journal of Surgery, ISSN 0007-1323, E-ISSN 1365-2168, Vol. 105, no 1, p. 121-127Article in journal (Refereed) Published
Abstract [en]

Background: There is a strong association between obesity and gallstones. However, there is no clear evidence regarding the optimal order of Roux-en-Y gastric bypass (RYGB) and cholecystectomy when both procedures are clinically indicated.

Methods: Based on cross-matched data from the Swedish Register for Cholecystectomy and Endoscopic Retrograde Cholangiopancreatography (GallRiks; 79 386 patients) and the Scandinavian Obesity Surgery Registry (SOReg; 36 098 patients) from 2007 to 2013, complication rates, reoperation rates and operation times related to the timing of RYGB and cholecystectomy were explored.

Results: There was a higher aggregate complication risk when cholecystectomy was performed after RYGB rather than before (odds ratio (OR) 1.35, 95 per cent c.i. 1.09 to 1.68; P=0.006). A complication after the first procedure independently increased the complication risk of the following procedure (OR 2.02, 1.44 to 2.85; P<0.001). Furthermore, there was an increased complication risk when cholecystectomy was performed at the same time as RYGB (OR 1.72, 1.14 to 2.60; P=0.010). Simultaneous cholecystectomy added 61.7 (95 per cent c.i. 56.1 to 67.4) min (P<0.001) to the duration of surgery.

Conclusion: Cholecystectomy should be performed before, not during or after, RYGB.

Place, publisher, year, edition, pages
John Wiley & Sons, 2018. Vol. 105, no 1, p. 121-127
National Category
Surgery
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URN: urn:nbn:se:umu:diva-143625DOI: 10.1002/bjs.10666ISI: 000418390500014PubMedID: 29044465OAI: oai:DiVA.org:umu-143625DiVA, id: diva2:1178566
Available from: 2018-01-30 Created: 2018-01-30 Last updated: 2018-06-09Bibliographically approved

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Enochsson, Lars

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CiteExportLink to record
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