Elkaseer, M. (2022). Concomitant versus Delayed Cholecystectomy in Morbidly Obese Patients with Asymptomatic Gall Stones Undergoing Laparoscopic Sleeve Gastrectomy. The Egyptian Journal of Hospital Medicine, 86(1), 958-962. doi: 10.21608/ejhm.2022.219971
Mohamed Hasan Mohamed Elkaseer. "Concomitant versus Delayed Cholecystectomy in Morbidly Obese Patients with Asymptomatic Gall Stones Undergoing Laparoscopic Sleeve Gastrectomy". The Egyptian Journal of Hospital Medicine, 86, 1, 2022, 958-962. doi: 10.21608/ejhm.2022.219971
Elkaseer, M. (2022). 'Concomitant versus Delayed Cholecystectomy in Morbidly Obese Patients with Asymptomatic Gall Stones Undergoing Laparoscopic Sleeve Gastrectomy', The Egyptian Journal of Hospital Medicine, 86(1), pp. 958-962. doi: 10.21608/ejhm.2022.219971
Elkaseer, M. Concomitant versus Delayed Cholecystectomy in Morbidly Obese Patients with Asymptomatic Gall Stones Undergoing Laparoscopic Sleeve Gastrectomy. The Egyptian Journal of Hospital Medicine, 2022; 86(1): 958-962. doi: 10.21608/ejhm.2022.219971
Concomitant versus Delayed Cholecystectomy in Morbidly Obese Patients with Asymptomatic Gall Stones Undergoing Laparoscopic Sleeve Gastrectomy
Background: Performing cholecystectomy concomitant to laparoscopic sleeve gastrectomy (LSG) in morbidly obese patients with asymptomatic cholelithiasis is poorly discussed. Objectives: We conducted the current investigation to compare concomitant to late cholecystectomy in asymptomatic gall stone patients undergoing LSG. Patients and methods: One hundred morbid obese patients scheduled for LSG were included in this retrospective analysis. They were divided into two groups: Group 1 included patients who underwent concomitant cholecystectomy, and group 2 that included patients who omitted such a procedure. Delayed cholecystectomy was scheduled if the patient developed symptoms related to gall bladder disease. The incidence of post-operative complications and percentage of developing symptomatic cholelithiasis in group 2 were our outcomes. Results: All preoperative data were statistically comparable between the two groups. However, operative time and intraoperative blood loss were significantly increased in group 1. The incidence of total early post-operative complications also increased in the same group (14% vs 0% in the other group). In Group 1, we encountered two patients with intraperitoneal bleeding (4%) who required laparoscopic management, in addition to the other two cases with biliary leakage (4%). In group 2, 18% of patients expressed symptomatic gall stone disease before the scheduled operation, while two cases (4%) developed acute complications that required early cholecystectomy. Conclusion: Cholecystectomy is associated with an increased incidence of early post-operative complications when performed in association with LSG. However, about 25% of asymptomatic cases who omitted the concomitant procedure will develop symptoms before the scheduled cholecystectomy.