title: Safety of concomitant cholecystectomy at the time of laparoscopic sleeve gastrectomy: analysis of the American College of Surgeons National Surgical Quality Improvement Program database.
abstract: BACKGROUND
  The indication and safety of concomitant cholecystectomy (CC) during bariatric surgical procedures are topics of controversy. Studies on the outcomes of CC with laparoscopic sleeve gastrectomy (LSG) are scarce.
  
  
  OBJECTIVE
  To assess the safety and 30-day surgical outcomes of CC with LSG.
  
  
  METHODS
  A retrospective analysis of the American College of Surgeons National Surgical Quality Improvement Program database 2010 to 2013. Univariate and multivariate analyses were used.
  
  
  RESULTS
  Between 2010 and 2013, 21,137 patients underwent LSG; of those 422 (2.0%) underwent CC (LSG+CC), and the majority (20,715 [98%]) underwent LSG alone. Patients in both groups were similar in age, sex distribution, baseline weight, and body mass index. The average surgical time was significantly higher, by 33 minutes, in the LSG+CC cohort. No differences were noted between the groups with regard to overall 30-day mortality and length of hospital stay. CC increased the odds of any adverse event (5.7% versus 4.0%), but the difference did not reach statistical significance (odds ratio 1.49, P = .07). Two complications were noted to be significantly higher with LSG+CC, namely bleeding (P = .04) and pneumonia (P = .02).
  
  
  CONCLUSIONS
  CC during LSG appears to be a safe procedure with slightly increased risk of bleeding and pneumonia compared with LSG alone. When factoring the potential risk and cost of further hospitalization for deferred cholecystectomy, these data support CC for established gallbladder disease.
authors.affiliation: Department of Surgery, American University of Beirut, Beirut, Lebanon.
authors.forename: Hanaa N
authors.initials: HN
authors.lastname: Dakour-Aridi
authors.affiliation: Department of Internal Medicine, American University of Beirut, Beirut, Lebanon.
authors.forename: Hebah M
authors.initials: HM
authors.lastname: El-Rayess
authors.affiliation: Department of Biochemistry and Molecular Genetics, American University of Beirut, Beirut, Lebanon.
authors.forename: Hussein
authors.initials: H
authors.lastname: Abou-Abbass
authors.affiliation: Department of Radiation Oncology, American University of Beirut, Beirut, Lebanon.
authors.forename: Ibrahim
authors.initials: I
authors.lastname: Abu-Gheida
authors.affiliation: Department of Internal Medicine and Outcomes Research Unit-Clinical Research Institute, American University of Beirut, Beirut, Lebanon.
authors.forename: Robert H
authors.initials: RH
authors.lastname: Habib
authors.affiliation: Department of Surgery, American University of Beirut, Beirut, Lebanon. Electronic address: bs21@aub.edu.lb.
authors.forename: Bassem Y
authors.initials: BY
authors.lastname: Safadi
mesh_terms: D000328:Adult; D000368:Aged; D050110:Bariatric Surgery / Q000009:adverse effects* / Q000379:methods; D016063:Blood Loss, Surgical; D017081:Cholecystectomy, Laparoscopic / Q000009:adverse effects / Q000379:methods; D003131:Combined Modality Therapy; D005260:Female; D005705:Gallbladder Diseases / Q000150:complications / Q000601:surgery; D005743:Gastrectomy / Q000009:adverse effects* / Q000379:methods; D006801:Humans; D010535:Laparoscopy / Q000009:adverse effects* / Q000379:methods; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D009767:Obesity, Morbid / Q000150:complications / Q000601:surgery; D061646:Operative Time; D011014:Pneumonia / Q000209:etiology; D011183:Postoperative Complications / Q000209:etiology; D012042:Registries; D012189:Retrospective Studies; D012307:Risk Factors
keywords: American College of Surgeons National Surgical Quality Improvement Program; Bariatric surgery; Cholecystectomy; Gallstones; Laparoscopic sleeve gastrectomy