title: Prophylactic cholecystectomy with gastric bypass operation: incidence of gallbladder disease.
abstract: 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.
authors.affiliation: Center For Surgical Treatment of Obesity, Tri-City Regional Hospital, Hawaiian Gardens, CA, USA. FOBIMAL@aol.com
authors.forename: Mal
authors.initials: M
authors.lastname: Fobi
authors.forename: Hoil
authors.initials: H
authors.lastname: Lee
authors.forename: Daniel
authors.initials: D
authors.lastname: Igwe
authors.forename: Basil
authors.initials: B
authors.lastname: Felahy
authors.forename: Elaine
authors.initials: E
authors.lastname: James
authors.forename: Malgorzata
authors.initials: M
authors.lastname: Stanczyk
authors.forename: Nicole
authors.initials: N
authors.lastname: Fobi
mesh_terms: 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