Asymptomatic cholelithiasis in bariatric practice

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Abstract

Background: The need for simultaneous cholecystectomy for asymptomatic cholelithiasis in patients undergoing bariatric intervention has not been proven. The experience of managing patients with obesity and concomitant disease — cholelithiasis is presented.

Aim: to determine the indications for simultaneous cholecystectomy and bariatric surgery in the combination of morbid obesity and a asymptomatic cholelithiasis.

Methods: The results of observation of 37 patients with initially asymptomatic cholelithiasis were analyzed: 27 patients underwent bariatric surgery and simultaneous cholecystectomy, and 10 patients underwent only bariatric surgery. The immediate and long-term results of the treatment, the quality of life of patients and the cost of the treatment were assessed.

Results: During 12 months of the follow-up, none of the patients who underwent simultaneous cholecystectomy developed any complications. Of the 10 patients in the observation group, 3 were operated on. Two patients underwent laparoscopic cholecystectomy for acute cholecystitis and one patient was operated on for choledocholithiasis with obstructive jaundice. The greatest improvement in the quality of life was observed in the gastric bypass group with simultaneous cholecystectomy. The treatment cost per patient was lower in that group, too.

Conclusion: In the presence of asymptomatic cholelithiasis in a patient with morbid obesity, bariatric intervention and simultaneous cholecystectomy prevents the development of complications of cholelithiasis and thereby potentially improves the quality of life and reduces the cost of medical care.

About the authors

Vladimir R. Stankevich

Federal Scientific and Clinical Center for Specialized Medical Assistance and Medical Technologies of the Federal Medical Biological Agency

Author for correspondence.
Email: v-stankevich@yandex.ru
ORCID iD: 0000-0002-8620-8755
SPIN-code: 5126-6092

MD, PhD

Russian Federation, 28, Orekhovy blvd, Moscow, 115682

Alexander V. Smirnov

Federal Scientific and Clinical Center for Specialized Medical Assistance and Medical Technologies of the Federal Medical Biological Agency

Email: alvsmirnov@mail.ru
ORCID iD: 0000-0003-3897-8306
SPIN-code: 5619-1151

MD, PhD

Russian Federation, 28, Orekhovy blvd, Moscow, 115682

Alexandr I. Zlobin

Federal Scientific and Clinical Center for Specialized Medical Assistance and Medical Technologies of the Federal Medical Biological Agency; Moscow State University of Medicine and Dentistry named after A.I. Evdokimov

Email: sancho-83@inbox.ru
ORCID iD: 0000-0002-8241-659X
SPIN-code: 2894-5059

MD, PhD

Russian Federation, 28, Orekhovy blvd, Moscow, 115682; Moscow

Dmitry N. Panchenkov

Federal Scientific and Clinical Center for Specialized Medical Assistance and Medical Technologies of the Federal Medical Biological Agency; Moscow State University of Medicine and Dentistry named after A.I. Evdokimov

Email: dnpanchenkov@mail.ru
ORCID iD: 0000-0001-8539-4392
SPIN-code: 4316-4651

MD, PhD, Professor

Russian Federation, 28, Orekhovy blvd, Moscow, 115682; Moscow

Valentin I. Sharobaro

The First Sechenov Moscow State Medical University (Sechenov University)

Email: sharobarovi@mail.ru
ORCID iD: 0000-0002-1510-9047
SPIN-code: 3677-0208

MD, PhD, Professor

Russian Federation, Moscow

Yury V. Ivanov

Federal Scientific and Clinical Center for Specialized Medical Assistance and Medical Technologies of the Federal Medical Biological Agency; Moscow State University of Medicine and Dentistry named after A.I. Evdokimov

Email: ivanovkb83@yandex.ru
ORCID iD: 0000-0001-6209-4194
SPIN-code: 3240-4335

MD, PhD, Professor

Russian Federation, 28, Orekhovy blvd, Moscow, 115682; Moscow

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Supplementary files

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2. Fig. 1. Increase in the integrated indicator of the quality of life EQ-VAS 12 months after the surgery. Note: ПРЖ — longitudinal resection of the stomach; ХЭ — simultaneous cholecystectomy.

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3. Fig. 2. Increase in the integrated indicator of the quality of life EQ-VAS 12 months after the surgery. When simultaneous cholecystectomy is performed, the following quality of life is 10 units higher on average (p=0.0232). Note: ГШ — gastric bypass, ХЭ — simultaneous cholecystectomy.

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