Cholecystectomy in Patients Submitted to Bariatric Procedure: A Systematic Review and Meta-analysis

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dc.contributor Sistema FMUSP-HC: Faculdade de Medicina da Universidade de São Paulo (FMUSP) e Hospital das Clínicas da FMUSP TUSTUMI, Francisco FMUSP-HC
dc.identifier.citation OBESITY SURGERY, v.28, n.10, p.3312-3320, 2018
dc.identifier.issn 0960-8923
dc.description.abstract Weight loss following bariatric surgery increases risk for biliary stones. This study performed a meta-analysis evaluating cholecystectomy risks in bariatric patients. A systematic review and meta-analysis were performed. We evaluated the incidence rate for biliary complications in patients followed after bariatric surgery. We compared the risks for mortality, complications, and in hospital stay among patient submitted to cholecystectomy before, concomitantly with or after bariatric surgery, as well as patients submitted to bariatric surgery and cholecystectomy, and patients submitted only to bariatric surgery in order to evaluate when to perform cholecystectomy in morbidly obese patients. The incidence rate of biliary complications was 5.54 cases/1000 patient year. The addition of cholecystectomy to bariatric surgery resulted in an increased risk for complications (RD = 0.02). The risk for complications (RD = - 0.09) and reoperation (RD = - 0.02) was lower when performed concomitantly with bariatric surgery compared to post-bariatric procedure. Prophylactic cholecystectomy may be avoided. Patients submitted to bariatric surgery have low incidence rate of biliary complications, and concomitant cholecystectomy increases the risk for postoperative complications and operative time. If cholecystectomy is not indicated, patients should be carefully followed with attention for biliary complications, once cholecystectomy performed post-bariatric surgery is at higher risk for complications and reoperations.
dc.language.iso eng
dc.publisher SPRINGER
dc.relation.ispartof Obesity Surgery
dc.rights restrictedAccess
dc.subject Meta-analysis; Obesity; Cholelithiasis; Weight loss; Bariatric surgery; Gastric bypass
dc.subject.other y gastric bypass; laparoscopic sleeve gastrectomy; rapid weight-loss; morbidly obese-patients; gallstone formation; routine cholecystectomy; concomitant cholecystectomy; ursodeoxycholic acid; prophylactic cholecystectomy; selective cholecystectomy
dc.title Cholecystectomy in Patients Submitted to Bariatric Procedure: A Systematic Review and Meta-analysis
dc.type article
dc.rights.holder Copyright SPRINGER LIM/35
dc.identifier.doi 10.1007/s11695-018-3443-1
dc.identifier.pmid 30097898
dc.type.category review
dc.type.version publishedVersion TUSTUMI, Francisco:HC:PAHC BERNARDO, Wanderley M.:FM: SANTO, Marco A.:FM:MGT CECCONELLO, Ivan:FM:MGT WOS:000444768500051 2-s2.0-85052102378 NEW YORK USA
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dc.description.index MEDLINE
dc.identifier.eissn 1708-0428
hcfmusp.citation.scopus 4
hcfmusp.citation.wos 3

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