Concomitant cholecystectomy during laparoscopic sleeve gastrectomy through the same four ports: feasibility and early results

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Abstract

Background
Up till now, the ideal therapeutic approach of cholelithiasis at the time of laparoscopic sleeve gastrectomy (LSG) is a matter of debate. The aim of this study was to report our experience regarding concomitant cholecystectomy (CC) during LSG through the same four ports.
Patients and methods
From January 2016 to February 2020, 70 morbidly obese patients were subjected to LSG, as the primary bariatric procedure, and CC for documented gallbladder pathology (study group), and they were compared with 384 morbidly obese patients subjected to just LSG (control group). This study discussed the preoperative patients’ demographics, preoperative comorbidities, operative technique, operative time, early and late complications, excess weight loss results, and assessment of postoperative pain. There was no significant statistical difference regarding age and preoperative BMI between both groups; however, the study group had more female predominance.
Results
All procedures were done laparoscopically through the same four ports without any additional trocars and no conversions. The main operative time extended by a mean of 25.81±7.59 min (range, 15–45 min) owing to CC, in the study group. There was no statistical difference regarding 24-h postoperative pain, morbidity rate, mean percentage of excess weight loss, and the mean length of hospital stay between both groups.
Conclusions
CC during LSG is feasible through the same ports, safe, and not associated with increased morbidity rate nor prolonged hospital stay; however, the operative time is prolonged. CC is better offered for morbidly obese patients with proven gallbladder disease, weather they are symptomatic or not, to avoid future complications.

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