The effect of concomitant cholecystectomy and sleeve gastrectomy on morbidity in high-risk obese patients with symptomatic gallstones.

Abstract

Introduction Obesity is an independent risk factor for gallstones. In obese patients, gallstone is more symptomatic than in non-obese people. Aim To present the early results of laparoscopic sleeve gastrectomy (LSG) and concomitant cholecystectomy (CC) performed in patients with symptomatic gallstone accompanied by at least one additional systemic disease to obesity and to investigate its effect on morbidity. Material and methods Patients undergoing sleeve gastrectomy for morbid obesity between January 2016 and August 2018 were retrospectively studied. Twenty-seven patients who underwent laparoscopic sleeve gastrectomy and concomitant cholecystectomy due to symptomatic gallstone stones were included in this study. The patients were divided into two groups according to the applied surgical technique: laparoscopic sleeve gastrectomy and concomitant cholecystectomy (n = 27) and laparoscopic sleeve gastrectomy (n = 70). The results of an additional operation on these patients and their perioperative complications were evaluated. Results A total of 97 patients were included in the study. The mean age of the patients was 40.58 ±10.36 years. There was no statistically significant difference between groups in terms of complications (p = 0.669). The difference in the duration of the operation was statistically significant (p < 0.001). Conclusions Concomitant cholecystectomy may be presented as an alternative surgical procedure due to the demonstration that concomitant cholecystectomy can be performed safely in comorbid obese patients, with a risk of becoming symptomatic in the rest of life at a certain rate, and low risk of complications in asymptomatic patients.

Type 2 Diabetes Remission 5 Years After Laparoscopic Sleeve Gastrectomy: Multicenter Cohort Study

“…Metabolic changes come hand in hand with weight loss, and hence, the resolution of metabolic disorders such as diabetes is possible. Knowledge of factors promoting diabetes remission together with recognition of both short-and mid-term outcomes of different procedures is crucial to enable conscious decision-making [15][16][17][18][19]. The topic of mid-term remissions after LRYGB has already been extensively studied [20,21].…”

Food Intolerance: The Role of Histamine

“…In the intestinal lumen, the level of histamine can be increased not only by oral consumption, but also probably as a result of decarboxylation of histidine of hemoglobin during gastrointestinal bleeding, intestinal obstruction, and septic conditions. An important source of histamine is the highly active histidine decarboxylases of the microbiota [ 29 , 30 ]; however, the phenomenon of increased histamine levels in septic conditions is still controversial [ 31 , 32 ].…”