Safety of concomitant laparoscopic cholecystectomy and laparoscopic sleeve gastrectomy in morbidly obese patients: A Meta-Analysis

Abstract

Background: Laparoscopic sleeve gastrectomy is one of the most common bariatric procedure performed. The prevalence of cholelithiasis in morbidly obese individuals is 19–30 % and Gall stones are more symptomatic in obese patients than in non-obese patients. This study evaluates the safety of performing laparoscopic sleeve gastrectomy and laparoscopic cholecystectomy in the same session. Objective: To evaluate the safety profile of performing laparoscopic cholecystectomy and sleeve gastrectomyin the same session in terms of : The incidence of biliary leakage. The incidence of gastric leakage. The incidence of intra operative bleeding from the sleeve gastrectomy and the cholecystectomy. The incidence of post-operative bleeding. The incidence of post-operative surgical site infection. Operation time. Length of hospital stay. Method: Selected papers for the present meta-analysis included those that provided data from January 2010 to December 2020 on factors related to the patients who undergone laparoscopic sleeve gastrectomy with and without laparoscopic cholecystectomy. When institutions have published duplicate trials, only the most updated reports were included for qualitative appraisal. All publications were limited to human subjects and English language. Abstracts, case reports, conference presentations, editorials and expert opinions were excluded. Data Sources: Medline databases (PubMed, Medscape, ScienceDirect. EMF-Portal) and all materials available in the Internet till 2021. Data Extraction: If the studies did not fulfill the inclusion criteria, they were excluded. Study quality assessment included whether ethical approval was gained, eligibility criteria specified, appropriate controls, and adequate information and defined assessment measures. Conclusion: Overall concomitant laparoscopic sleeve gastrectomy and laparoscopic cholecystectomy appears to be a safe procedure. The increase in surgical site infection and pneumonia may warrant prophylaxis against such infections with antibiotics. Another study is needed to determine the need and efficacy of such prophylaxis