title: A Technique for Simultaneous Cholecystectomy During Bariatric Surgery.
abstract: OBJECTIVE
  Cholecystectomy performed during bariatric surgery is technically demanding. Herein is described a technique we term the Glissonian approach along with an evaluation of its effectiveness and safety.
  
  
  METHODS
  From April 1, 2009, through February 28, 2014, laparoscopic cholecystectomy was performed during laparoscopic Roux-en-Y gastric bypass (LRYGB) or laparoscopic sleeve gastrectomy (LSG) in 38 patients with proven cholecystopathy on diagnostic imaging. Perioperative outcomes were compared between the patients operated on with the Glissonian approach and those who underwent conventional laparoscopic cholecystectomy.
  
  
  RESULTS
  The Glissonian approach was adopted in 13 patients-11 during LRYGB and 2 during LSG-and the conventional operation was performed on 16 patients during LRYGB and 9 during LSG. Mean body mass indexes were 40.1 kg/m(2) in the Glissonian-approach group and 37.6 kg/m(2) in the conventional group. Laparoscopic cholecystectomy by the Glissonian approach saved a mean operative time of 7 minutes compared with the operative time of the conventional operation. No surgical complications related to cholecystectomy were noted in either group.
  
  
  CONCLUSIONS
  This simple technique can be performed safely in morbidly obese patients, with low resultant morbidity and acceptable operation times.
authors.affiliation: Department of Surgery, Hanyang University College of Medicine, Seoul, Korea.
authors.forename: Ju-Hee
authors.initials: JH
authors.lastname: Lee
authors.affiliation: Department of Surgery, Soonchunhyang University College of Medicine, Seoul, Korea.
authors.forename: Guru
authors.initials: G
authors.lastname: Han
authors.affiliation: Department of Surgery, Soonchunhyang University College of Medicine, Seoul, Korea.
authors.forename: Yong Jin
authors.initials: YJ
authors.lastname: Kim
authors.affiliation: Department of Surgery, Hanyang University College of Medicine, Seoul, Korea.
authors.forename: Min-Sung
authors.initials: MS
authors.lastname: Jung
authors.affiliation: Department of Surgery, Hanyang University College of Medicine, Seoul, Korea.
authors.forename: Dongho
authors.initials: D
authors.lastname: Choi
mesh_terms: D000328:Adult; D017081:Cholecystectomy, Laparoscopic / Q000379:methods; D005260:Female; D005743:Gastrectomy; D015390:Gastric Bypass; D006801:Humans; D008297:Male; D061646:Operative Time; D012189:Retrospective Studies
keywords: Cholecystectomy; Glissonian approach; Morbid obesity