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Cholecystectomy concomitant with laparoscopic gastric bypass: a trend analysis of the nationwide inpatient sample from 2001 to 2008.

Publication ,  Journal Article
Worni, M; Guller, U; Shah, A; Gandhi, M; Shah, J; Rajgor, D; Pietrobon, R; Jacobs, DO; Ostbye, T
Published in: Obes Surg
February 2012

BACKGROUND: Gallstone formation is common in obese patients, particularly during rapid weight loss. Whether a concomitant cholecystectomy should be performed during laparoscopic gastric bypass surgery is still contentious. We aimed to analyze trends in concomitant cholecystectomy and laparoscopic gastric bypass surgery (2001-2008), to identify factors associated with concomitant cholecystectomy, and to compare short-term outcomes after laparoscopic gastric bypass with and without concomitant cholecystectomy. METHODS: We used data from adults undergoing laparoscopic gastric bypass for obesity from the Nationwide Inpatient Sample. The Cochran-Armitage trend test was used to assess changes over time. Unadjusted and risk-adjusted generalized linear models were performed to assess predictors of concomitant cholecystectomy and to assess postoperative short-term outcomes. RESULTS: A total of 70,287 patients were included: mean age was 43.1 years and 81.6% were female. Concomitant cholecystectomy was performed in 6,402 (9.1%) patients. The proportion of patients undergoing concomitant cholecystectomy decreased significantly from 26.3% in 2001 to 3.7% in 2008 (p for trend < 0.001). Patients who underwent concomitant cholecystectomy had higher rates of mortality (unadjusted odds ratios [OR], 2.16; p = 0.012), overall postoperative complications (risk-adjusted OR, 1.59; p = 0.001), and reinterventions (risk-adjusted OR, 3.83; p < 0.001), less frequent routine discharge (risk-adjusted OR, 0.70; p = 0.05), and longer adjusted hospital stay (median difference, 0.4 days; p < 0.001). CONCLUSIONS: Concomitant cholecystectomy and laparoscopic gastric bypass surgery have decreased significantly over the last decade. Given the higher rates of postoperative complications, reinterventions, mortality, as well as longer hospital stay, concomitant cholecystectomy should only be considered in patients with symptomatic gallbladder disease.

Duke Scholars

Published In

Obes Surg

DOI

EISSN

1708-0428

Publication Date

February 2012

Volume

22

Issue

2

Start / End Page

220 / 229

Location

United States

Related Subject Headings

  • Weight Loss
  • United States
  • Treatment Outcome
  • Time Factors
  • Surgery
  • Sampling Studies
  • Retrospective Studies
  • Reoperation
  • Postoperative Complications
  • Patient Selection
 

Citation

APA
Chicago
ICMJE
MLA
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Worni, M., Guller, U., Shah, A., Gandhi, M., Shah, J., Rajgor, D., … Ostbye, T. (2012). Cholecystectomy concomitant with laparoscopic gastric bypass: a trend analysis of the nationwide inpatient sample from 2001 to 2008. Obes Surg, 22(2), 220–229. https://doi.org/10.1007/s11695-011-0575-y
Worni, Mathias, Ulrich Guller, Anand Shah, Mihir Gandhi, Jatin Shah, Dimple Rajgor, Ricardo Pietrobon, Danny O. Jacobs, and Truls Ostbye. “Cholecystectomy concomitant with laparoscopic gastric bypass: a trend analysis of the nationwide inpatient sample from 2001 to 2008.Obes Surg 22, no. 2 (February 2012): 220–29. https://doi.org/10.1007/s11695-011-0575-y.
Worni M, Guller U, Shah A, Gandhi M, Shah J, Rajgor D, et al. Cholecystectomy concomitant with laparoscopic gastric bypass: a trend analysis of the nationwide inpatient sample from 2001 to 2008. Obes Surg. 2012 Feb;22(2):220–9.
Worni, Mathias, et al. “Cholecystectomy concomitant with laparoscopic gastric bypass: a trend analysis of the nationwide inpatient sample from 2001 to 2008.Obes Surg, vol. 22, no. 2, Feb. 2012, pp. 220–29. Pubmed, doi:10.1007/s11695-011-0575-y.
Worni M, Guller U, Shah A, Gandhi M, Shah J, Rajgor D, Pietrobon R, Jacobs DO, Ostbye T. Cholecystectomy concomitant with laparoscopic gastric bypass: a trend analysis of the nationwide inpatient sample from 2001 to 2008. Obes Surg. 2012 Feb;22(2):220–229.
Journal cover image

Published In

Obes Surg

DOI

EISSN

1708-0428

Publication Date

February 2012

Volume

22

Issue

2

Start / End Page

220 / 229

Location

United States

Related Subject Headings

  • Weight Loss
  • United States
  • Treatment Outcome
  • Time Factors
  • Surgery
  • Sampling Studies
  • Retrospective Studies
  • Reoperation
  • Postoperative Complications
  • Patient Selection