title: Non-complicated cholelithiasis associated with GERD. Results of combined laparoscopic surgery in low risk patients.
abstract: BACKGROUND
  the aim of this study was to evaluate the efficacy of combined laparoscopic surgery for non-complicated cholelithiasis and gastroesophageal reflux disease (GERD) in patients with low surgical risk.
  
  
  METHODS
  a total of 680 cholecystectomies performed by means of laparoscopic surgery were retrospectively studied from February 1991 to February 2002. A total of 442 patients that fulfilled the inclusion criteria were divided into two groups: group A: non-complicated cholelithiasis (cholecystectomy alone), consisting of a total of 362 patients, and group B: non-complicated cholelithiasis and GERD (cholecystectomy and Toupet's fundoplication in all cases) in 80 patients. Demographic and clinical data, intraoperatory incidences, and post-surgical complications were prospectively collected and compared for all patients. The results of reflux surgery (group B) were evaluated at 6 months by means of 24-hour pH-metry.
  
  
  RESULTS
  in spite of the fact that the group undergoing combined surgery consisted of patients with greater weight and older age (p < 0.05), no significant differences were found in the number of intraoperative incidences and post-surgical complications between both groups (NS). Significant differences were only found in the duration of surgery: 48 +/- 25 min (10-150) in group A compared to 112 +/- 23 min (80-180) in group B (p<0.001), and in the return to normal daily activities (5.8 +/- 0.9 days vs 6.5 +/- 1 days in group B) (p< 0.001). In the latter group a normalization of 24-hour pH-metry values and an absence of symptoms associated with reflux were observed in all cases.
  
  
  CONCLUSIONS
  in patients younger than 75 years with low surgical risk and non-complicated cholelithiasis and GERD, both illnesses can be resolved during the same surgical procedure by laparoscopy with no increased risk or postoperative complications.
authors.affiliation: Service of General Surgery and Digestive Diseases, Central Hospital of Asturias, Oviedo, Spain.
authors.forename: F
authors.initials: F
authors.lastname: Pozo
authors.forename: F
authors.initials: F
authors.lastname: Giganto
authors.forename: L
authors.initials: L
authors.lastname: RAodrigo
mesh_terms: D000328:Adult; D000368:Aged; D017081:Cholecystectomy, Laparoscopic; D002769:Cholelithiasis / Q000150:complications / Q000601:surgery*; D005260:Female; D005764:Gastroesophageal Reflux / Q000150:complications / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012189:Retrospective Studies; D012307:Risk Factors