Simultaneous gastric banding and cholecystectomy in the treatment of morbid obesity: is it feasible?
BACKGROUND
In the last decade, laparoscopic surgery for morbid obesity has become widely employed, including a marked increase in the placement of adjustable gastric bands (AGB). Among the co-morbidities of morbid obesity is cholelithiasis. The question arises whether concomitant cholecystectomy increases the risk of postoperative infectious complications due to the association of a potentially contaminated procedure with a clean operation, placement of an AGB. The aim of this study is to evaluate the postoperative outcome in patients submitted to laparoscopic AGB with cholecystectomy.


METHODS
From January 2000 to January 2004, 308 patients (85 men and 223 women) had AGB placed. BMI ranged from 38.9 to 65.6 kg/m(2) (mean 41.6). In 17 patients (5.5%), gallstones were detected by ultrasonography, and cholecystectomy was performed together with the AGB. Mean operative time for placement of the AGB was 58 +/- 18 min, and in those with cholecystectomy 86 +/- 17 min (P =0.20).


RESULTS
All patients that had placement of AGB and cholecystectomy had satisfactory postoperative outcome. No infectious complications were observed.


CONCLUSIONS
Laparoscopic cholecystectomy performed simultaneously with placement of an AGB has been a safe procedure.
Zilberstein
Bruno
B
Gastromed, Zilberstein Institute, São Paulo, SP, Brazil. brunozilb@uol.com.br
Pajecki
Denis
D
Andrade
Carla Granja
CG
Eshkenazy
Rony
R
Garcia de Brito
Alex Cleiton
AC
Gallafrio
Samuel Terra
ST
D000293:Adolescent; D000328:Adult; D001938:Brazil; D017081:Cholecystectomy, Laparoscopic / Q000009:adverse effects / Q000379:methods*; D002769:Cholelithiasis / Q000175:diagnosis / Q000453:epidemiology / Q000601:surgery*; D015331:Cohort Studies; D003131:Combined Modality Therapy; D015897:Comorbidity; D005240:Feasibility Studies; D005260:Female; D005500:Follow-Up Studies; D015905:Gastric Balloon; D015391:Gastroplasty / Q000009:adverse effects / Q000379:methods*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009767:Obesity, Morbid / Q000175:diagnosis / Q000453:epidemiology / Q000601:surgery*; D011183:Postoperative Complications / Q000453:epidemiology; D011336:Probability; D018570:Risk Assessment; D012720:Severity of Illness Index; D016896:Treatment Outcome