Prophylactic cholecystectomy with gastric bypass operation: incidence of gallbladder disease.
BACKGROUND
Morbid obesity is one of the major risk factors for gallbladder disease, and this risk is even greater following rapid weight loss. Because of this, prophylactic cholecystectomy has been offered to our patients undergoing the transected silastic ring vertical Roux-en-Y gastric bypass (TSRVRYGBP). A study was undertaken to determine the incidence of pathologic gallbladders in patients undergoing this prophylactic cholecystectomy.


METHODS
The records of all patients who underwent TSRVRYGBP from June 1999 through December 2000 were reviewed. Pathologic findings of the gallbladder were documented as cholelithiasis, cholecystitis, cholesterolosis, polyps or normal.


RESULTS
761 patients underwent the operation. 178 patients (23%) had cholecystectomy before the surgery. 154 (20%) had gallstones documented by ultrasound and had cholecystectomy at the time of the surgery. 324 of the 429 patients with negative preoperative findings by ultrasound had pathologic evidence of gallbladder disease.


CONCLUSIONS
Because of the high incidence of gallbladder disease even with negative preoperative findings in morbidly obese patients and the lack of significant morbidity with cholecystectomy in experienced hands, routine cholecystectomy at the time of the weight loss operation is justified.
Fobi
Mal
M
Center For Surgical Treatment of Obesity, Tri-City Regional Hospital, Hawaiian Gardens, CA, USA. FOBIMAL@aol.com
Lee
Hoil
H
Igwe
Daniel
D
Felahy
Basil
B
James
Elaine
E
Stanczyk
Malgorzata
M
Fobi
Nicole
N
D000328:Adult; D000713:Anastomosis, Roux-en-Y / Q000009:adverse effects* / Q000191:economics*; D015992:Body Mass Index; D002763:Cholecystectomy / Q000009:adverse effects* / Q000191:economics*; D003362:Cost-Benefit Analysis / Q000191:economics; D005260:Female; D005705:Gallbladder Diseases / Q000453:epidemiology / Q000209:etiology* / Q000517:prevention & control*; D015390:Gastric Bypass / Q000009:adverse effects* / Q000191:economics*; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009767:Obesity, Morbid / Q000150:complications* / Q000503:physiopathology / Q000601:surgery*; D011183:Postoperative Complications; D012189:Retrospective Studies; D015431:Weight Loss / Q000502:physiology