A rational approach to cholelithiasis in bariatric surgery

By pe o’brien · 2003 · cited by 92 — placement of an adjustable gastric banding system (lap- ... port placement was generally not ideal, as we at- ... no acute admissions for acute chole-.
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A Rational Approach to Cholelithiasisin Bariatric SurgeryIts Application to the Laparoscopically Placed Adjustable Gastric BandPaul E. O’Brien, MD, FRACS; John B. Dixon, MBBS, FRACGPBackground: Gallstones are more common in the obesepopulation and may be formed during rapid weight loss.A rational approach to the management of the gallblad-der should be incorporated into bariatric surgical prac-tice. It has been recommended that patients undergoingRoux-en-Y gastric bypass have routine cholecystectomyregardless of gallstone status. We analyzed the out-comes of a noninterventionist policy on 1000 patientsundergoing laparoscopic adjustable gastric banding.Hypothesis: Patients scheduled for adjustable gastricbanding should undergo investigation for and treat-ment of gallbladder disease regardless of symptoms.Methods: Patients were screened preoperatively forsymptoms of gallstones. Ultrasound examination was per-formed only in those with symptoms and, if stones werepresent, cholecystectomy w...