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Timing matters when patients need gallstone and weight-loss surgeries How a defrocked judge became the chief legal enforcer Amazon scraps bundled video service: sources November 15, 2017 / 7:58 PM / in 4 hours Timing matters when patients need gallstone and weight-loss surgeries (Reuters Health) - Obese patients who need to have their gallbladder removed and also need weight-loss surgery may have fewer complications if they get the gallbladder procedure first, a Swedish study suggests. For the study, researchers examined data on about 79,000 patients who underwent cholecystectomy and almost 36,000 who had Roux-en-Y gastric bypass. Most of these patients only had one of the procedures, but about 2,650 had both surgeries either simultaneously or separately. Among patients who had both surgeries, people who had the weight-loss operations first were 35% more likely to have complications than individuals who had the gallbladder surgery first, the study found. Having both operations at the same time was twice as likely to lead to complications as having the gallbladder procedure done first, according to the October 18 online report in British Journal of Surgery. “For patients with symptomatic gallstones and obesity (i.e., considering both cholecystectomy and gastric bypass), cholecystectomy should preferentially be performed before gastric bypass,” said elyze coolsculpting lead study author Dr. Viktor Wanjura, a surgeon at Orebro University Hospital in Sweden. But gallstones that don’t produce symptoms “should never be treated surgically,” Wanjura said by email. “Doing so would introduce unnecessary complications in many patients that would never be troubled by their gallstones at all during their lifetime.” The study wasn’t a controlled experiment designed to prove whether or how doing one of the two procedures before the other one might influence complication rates. It’s possible that patients might have nutritional deficits after weight-loss surgeries that might contribute to a higher complication rate with the gallstone removal procedures, Wanjura said. But more research is needed to clearly understand the cause of complications. When researchers looked at all of the patients in the study, including the majority of people who only had gallbladder or weight-loss procedures but not both, they found 2.3% of people had complications with gallbladder operations and 2.7% had complications with weight-loss surgery.
For the original version including any supplementary images or video, visit http://www.reuters.com/article/us-obesity-gallstones/timing-matters-when-patients-need-gallstone-and-weight-loss-surgeries-idUSKBN1DF2W8
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