EP.TH.210Our Take on Prophylactic Cholecytectomy in Patients Undergoing Bariatric Laparoscopic Roux En Y Gastric Bypass (Lrygb)

Abstract

Aim: The concept of prophylactic cholecystectomy in bariatric patients undergoing laparoscopic roux en y gastric bypass despite extensive discussion remains controversial. We aim to resolve this controversy by our observational study. Method: Data extracted fromour prospective Bariatric and theater database between 2012 and 2018 of patients having undergone roux en Y bypass and laparoscopic cholecytectomy in a retrospective manner. The primary endpoint was determining the incidence of laparoscopic cholecystectomy in bariatric bypass patients. The second endpoint of data analysis was to compare the outcomes between post laparoscopic roux en y gastric bypass and laparoscopic cholecystectomy in non bariatric. Results: Incidence of laparoscopic cholecystectomy in 511 LRYGB patients was 19.17%. These were performed before (9.70%), after (7.20%) and concomitantly (2.15%). Ultrasound was done in 71.60% of patients of which 28.10% had evidence of Gallstones. MRCP was done in 1.56% for suspected CBD stone before LRYGB and 4.10% after LRYGB. Only 2(0.39%) patients required a laparoscopic assisted ERCP. Over all complications from Laparoscopic cholecytectomy performed after or concomitantly with LRYGB was similar to the non bariatric cohort. Conclusion: We reported a low incidence of post and concomitant laparoscopic cholecystectomy There was no statistical deference in post operative complications from laparoscopic cholesystectomy between LRYGB and non bariatric population. To conclude there is no evidence support prophylactic cholecystectomy. However, a randomized controlled trial should be considered to support our conclusion.