There is a strong association between obesity and gallstones; however, there is no clear evidence regarding the optimal order of gastric bypass surgery and gallbladder surgery (cholecystectomy) when both procedures are clinically indicated. In a BJS (British Journal of Surgery) analysis, there was a higher risk of complications when cholecystectomy was performed after bypass surgery rather than before.
The analysis was based on data from the Swedish Register for Cholecystectomy and Endoscopic Retrograde Cholangiopancreatography (79,386 patients) and the Scandinavian Obesity Surgery Registry (36,098 patients) from 2007 to 2013.
"For patients with obesity and symptomatic gallstone disease, the best strategy complication-wise is to perform cholecystectomy before gastric bypass," said lead author Viktor Wanjura, of Örebro University, in Sweden.
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British Journal of Surgery (2017). DOI: 10.1002/bjs.10666