Morbidity of cholecystectomy and gastric bypass in a national databaseShow others and affiliations
2018 (English)In: British Journal of Surgery, ISSN 0007-1323, E-ISSN 1365-2168, Vol. 105, no 1, p. 121-127Article in journal (Refereed) Published
Abstract [en]
BACKGROUND: There is a strong association between obesity and gallstones. However, there is no clear evidence regarding the optimal order of Roux-en-Y gastric bypass (RYGB) and cholecystectomy when both procedures are clinically indicated.
METHODS: Based on cross-matched data from the Swedish Register for Cholecystectomy and Endoscopic Retrograde Cholangiopancreatography (GallRiks; 79 386 patients) and the Scandinavian Obesity Surgery Registry (SOReg; 36 098 patients) from 2007 to 2013, complication rates, reoperation rates and operation times related to the timing of RYGB and cholecystectomy were explored.
RESULTS: There was a higher aggregate complication risk when cholecystectomy was performed after RYGB rather than before (odds ratio (OR) 1·35, 95 per cent c.i. 1·09 to 1·68; P = 0·006). A complication after the first procedure independently increased the complication risk of the following procedure (OR 2·02, 1·44 to 2·85; P < 0·001). Furthermore, there was an increased complication risk when cholecystectomy was performed at the same time as RYGB (OR 1·72, 1·14 to 2·60; P = 0·010). Simultaneous cholecystectomy added 61·7 (95 per cent c.i. 56·1 to 67·4) min (P < 0·001) to the duration of surgery.
CONCLUSION: Cholecystectomy should be performed before, not during or after, RYGB.
Place, publisher, year, edition, pages
John Wiley & Sons, 2018. Vol. 105, no 1, p. 121-127
National Category
Surgery
Identifiers
URN: urn:nbn:se:oru:diva-62417DOI: 10.1002/bjs.10666ISI: 000418390500014PubMedID: 29044465Scopus ID: 2-s2.0-85031507645OAI: oai:DiVA.org:oru-62417DiVA, id: diva2:1164540
Funder
Stiftelsen Olle Engkvist Byggmästare
Note
Funding Agencies:
Örebro University Research Committee
Nyckelfonden Örebro
2017-12-112017-12-112020-12-01Bibliographically approved