Cholecystectomy concomitant with laparoscopic gastric bypass: A trend analysis of the nationwide inpatient sample from 2001 to 2008

Mathias Worni, Ulrich Guller, Anand Shah, Mihir Gandhi, Jatin Shah, Dimple Rajgor, Ricardo Pietrobon, Danny O. Jacobs, Truls Stbye

Research output: Contribution to journalArticle

59 Citations (Scopus)

Abstract

Background: Gallstone formation is common in obese patients, particularly during rapid weight loss. Whether a concomitant cholecystectomy should be performed during laparoscopic gastric bypass surgery is still contentious. We aimed to analyze trends in concomitant cholecystectomy and laparoscopic gastric bypass surgery (2001-2008), to identify factors associated with concomitant cholecystectomy, and to compare short-term outcomes after laparoscopic gastric bypass with and without concomitant cholecystectomy. Methods: We used data from adults undergoing laparoscopic gastric bypass for obesity from the Nationwide Inpatient Sample. The Cochran-Armitage trend test was used to assess changes over time. Unadjusted and risk-adjusted generalized linear models were performed to assess predictors of concomitant cholecystectomy and to assess postoperative short-term outcomes. Results: A total of 70,287 patients were included: mean age was 43.1 years and 81.6% were female. Concomitant cholecystectomy was performed in 6,402 (9.1%) patients. The proportion of patients undergoing concomitant cholecystectomy decreased significantly from 26.3% in 2001 to 3.7% in 2008 (p for trend < 0.001). Patients who underwent concomitant cholecystectomy had higher rates of mortality (unadjusted odds ratios [OR], 2.16; p = 0.012), overall postoperative complications (risk-adjusted OR, 1.59; p = 0.001), and reinterventions (risk-adjusted OR, 3.83; p < 0.001), less frequent routine discharge (risk-adjusted OR, 0.70; p = 0.05), and longer adjusted hospital stay (median difference, 0.4 days; p < 0.001). Conclusions: Concomitant cholecystectomy and laparoscopic gastric bypass surgery have decreased significantly over the last decade. Given the higher rates of postoperative complications, reinterventions, mortality, as well as longer hospital stay, concomitant cholecystectomy should only be considered in patients with symptomatic gallbladder disease.

Original languageEnglish
Pages (from-to)220-229
Number of pages10
JournalObesity Surgery
Volume22
Issue number2
DOIs
StatePublished - Feb 2012
Externally publishedYes

Fingerprint

Gastric Bypass
Cholecystectomy
Inpatients
Odds Ratio
Laparoscopic Cholecystectomy
Length of Stay
Gallbladder Diseases
Mortality
Gallstones
Weight Loss
Linear Models
Obesity

Keywords

  • Adverse outcomes
  • Bariatric surgery
  • Cholecystectomy
  • Gallstones
  • Laparoscopic gastric bypass

ASJC Scopus subject areas

  • Surgery
  • Endocrinology, Diabetes and Metabolism
  • Nutrition and Dietetics

Cite this

Cholecystectomy concomitant with laparoscopic gastric bypass : A trend analysis of the nationwide inpatient sample from 2001 to 2008. / Worni, Mathias; Guller, Ulrich; Shah, Anand; Gandhi, Mihir; Shah, Jatin; Rajgor, Dimple; Pietrobon, Ricardo; Jacobs, Danny O.; Stbye, Truls.

In: Obesity Surgery, Vol. 22, No. 2, 02.2012, p. 220-229.

Research output: Contribution to journalArticle

Worni, M, Guller, U, Shah, A, Gandhi, M, Shah, J, Rajgor, D, Pietrobon, R, Jacobs, DO & Stbye, T 2012, 'Cholecystectomy concomitant with laparoscopic gastric bypass: A trend analysis of the nationwide inpatient sample from 2001 to 2008', Obesity Surgery, vol. 22, no. 2, pp. 220-229. https://doi.org/10.1007/s11695-011-0575-y
Worni, Mathias ; Guller, Ulrich ; Shah, Anand ; Gandhi, Mihir ; Shah, Jatin ; Rajgor, Dimple ; Pietrobon, Ricardo ; Jacobs, Danny O. ; Stbye, Truls. / Cholecystectomy concomitant with laparoscopic gastric bypass : A trend analysis of the nationwide inpatient sample from 2001 to 2008. In: Obesity Surgery. 2012 ; Vol. 22, No. 2. pp. 220-229.
@article{0678d2f851134ce88838b172f0e66a4d,
title = "Cholecystectomy concomitant with laparoscopic gastric bypass: A trend analysis of the nationwide inpatient sample from 2001 to 2008",
abstract = "Background: Gallstone formation is common in obese patients, particularly during rapid weight loss. Whether a concomitant cholecystectomy should be performed during laparoscopic gastric bypass surgery is still contentious. We aimed to analyze trends in concomitant cholecystectomy and laparoscopic gastric bypass surgery (2001-2008), to identify factors associated with concomitant cholecystectomy, and to compare short-term outcomes after laparoscopic gastric bypass with and without concomitant cholecystectomy. Methods: We used data from adults undergoing laparoscopic gastric bypass for obesity from the Nationwide Inpatient Sample. The Cochran-Armitage trend test was used to assess changes over time. Unadjusted and risk-adjusted generalized linear models were performed to assess predictors of concomitant cholecystectomy and to assess postoperative short-term outcomes. Results: A total of 70,287 patients were included: mean age was 43.1 years and 81.6{\%} were female. Concomitant cholecystectomy was performed in 6,402 (9.1{\%}) patients. The proportion of patients undergoing concomitant cholecystectomy decreased significantly from 26.3{\%} in 2001 to 3.7{\%} in 2008 (p for trend < 0.001). Patients who underwent concomitant cholecystectomy had higher rates of mortality (unadjusted odds ratios [OR], 2.16; p = 0.012), overall postoperative complications (risk-adjusted OR, 1.59; p = 0.001), and reinterventions (risk-adjusted OR, 3.83; p < 0.001), less frequent routine discharge (risk-adjusted OR, 0.70; p = 0.05), and longer adjusted hospital stay (median difference, 0.4 days; p < 0.001). Conclusions: Concomitant cholecystectomy and laparoscopic gastric bypass surgery have decreased significantly over the last decade. Given the higher rates of postoperative complications, reinterventions, mortality, as well as longer hospital stay, concomitant cholecystectomy should only be considered in patients with symptomatic gallbladder disease.",
keywords = "Adverse outcomes, Bariatric surgery, Cholecystectomy, Gallstones, Laparoscopic gastric bypass",
author = "Mathias Worni and Ulrich Guller and Anand Shah and Mihir Gandhi and Jatin Shah and Dimple Rajgor and Ricardo Pietrobon and Jacobs, {Danny O.} and Truls Stbye",
year = "2012",
month = "2",
doi = "10.1007/s11695-011-0575-y",
language = "English",
volume = "22",
pages = "220--229",
journal = "Obesity Surgery",
issn = "0960-8923",
publisher = "Springer New York",
number = "2",

}

TY - JOUR

T1 - Cholecystectomy concomitant with laparoscopic gastric bypass

T2 - A trend analysis of the nationwide inpatient sample from 2001 to 2008

AU - Worni, Mathias

AU - Guller, Ulrich

AU - Shah, Anand

AU - Gandhi, Mihir

AU - Shah, Jatin

AU - Rajgor, Dimple

AU - Pietrobon, Ricardo

AU - Jacobs, Danny O.

AU - Stbye, Truls

PY - 2012/2

Y1 - 2012/2

N2 - Background: Gallstone formation is common in obese patients, particularly during rapid weight loss. Whether a concomitant cholecystectomy should be performed during laparoscopic gastric bypass surgery is still contentious. We aimed to analyze trends in concomitant cholecystectomy and laparoscopic gastric bypass surgery (2001-2008), to identify factors associated with concomitant cholecystectomy, and to compare short-term outcomes after laparoscopic gastric bypass with and without concomitant cholecystectomy. Methods: We used data from adults undergoing laparoscopic gastric bypass for obesity from the Nationwide Inpatient Sample. The Cochran-Armitage trend test was used to assess changes over time. Unadjusted and risk-adjusted generalized linear models were performed to assess predictors of concomitant cholecystectomy and to assess postoperative short-term outcomes. Results: A total of 70,287 patients were included: mean age was 43.1 years and 81.6% were female. Concomitant cholecystectomy was performed in 6,402 (9.1%) patients. The proportion of patients undergoing concomitant cholecystectomy decreased significantly from 26.3% in 2001 to 3.7% in 2008 (p for trend < 0.001). Patients who underwent concomitant cholecystectomy had higher rates of mortality (unadjusted odds ratios [OR], 2.16; p = 0.012), overall postoperative complications (risk-adjusted OR, 1.59; p = 0.001), and reinterventions (risk-adjusted OR, 3.83; p < 0.001), less frequent routine discharge (risk-adjusted OR, 0.70; p = 0.05), and longer adjusted hospital stay (median difference, 0.4 days; p < 0.001). Conclusions: Concomitant cholecystectomy and laparoscopic gastric bypass surgery have decreased significantly over the last decade. Given the higher rates of postoperative complications, reinterventions, mortality, as well as longer hospital stay, concomitant cholecystectomy should only be considered in patients with symptomatic gallbladder disease.

AB - Background: Gallstone formation is common in obese patients, particularly during rapid weight loss. Whether a concomitant cholecystectomy should be performed during laparoscopic gastric bypass surgery is still contentious. We aimed to analyze trends in concomitant cholecystectomy and laparoscopic gastric bypass surgery (2001-2008), to identify factors associated with concomitant cholecystectomy, and to compare short-term outcomes after laparoscopic gastric bypass with and without concomitant cholecystectomy. Methods: We used data from adults undergoing laparoscopic gastric bypass for obesity from the Nationwide Inpatient Sample. The Cochran-Armitage trend test was used to assess changes over time. Unadjusted and risk-adjusted generalized linear models were performed to assess predictors of concomitant cholecystectomy and to assess postoperative short-term outcomes. Results: A total of 70,287 patients were included: mean age was 43.1 years and 81.6% were female. Concomitant cholecystectomy was performed in 6,402 (9.1%) patients. The proportion of patients undergoing concomitant cholecystectomy decreased significantly from 26.3% in 2001 to 3.7% in 2008 (p for trend < 0.001). Patients who underwent concomitant cholecystectomy had higher rates of mortality (unadjusted odds ratios [OR], 2.16; p = 0.012), overall postoperative complications (risk-adjusted OR, 1.59; p = 0.001), and reinterventions (risk-adjusted OR, 3.83; p < 0.001), less frequent routine discharge (risk-adjusted OR, 0.70; p = 0.05), and longer adjusted hospital stay (median difference, 0.4 days; p < 0.001). Conclusions: Concomitant cholecystectomy and laparoscopic gastric bypass surgery have decreased significantly over the last decade. Given the higher rates of postoperative complications, reinterventions, mortality, as well as longer hospital stay, concomitant cholecystectomy should only be considered in patients with symptomatic gallbladder disease.

KW - Adverse outcomes

KW - Bariatric surgery

KW - Cholecystectomy

KW - Gallstones

KW - Laparoscopic gastric bypass

UR - http://www.scopus.com/inward/record.url?scp=84857368970&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84857368970&partnerID=8YFLogxK

U2 - 10.1007/s11695-011-0575-y

DO - 10.1007/s11695-011-0575-y

M3 - Article

C2 - 22183984

AN - SCOPUS:84857368970

VL - 22

SP - 220

EP - 229

JO - Obesity Surgery

JF - Obesity Surgery

SN - 0960-8923

IS - 2

ER -