Application of sleeve gastrectomy in obese patients with acute calculous cholecystitis

Abstract

Objective To investigate the application value of laparoscopic sleeve gastrectomy(LSG) in obese patients with acute calculous cholecystitis, to explore the safety of the LSG combined with laparoscopic cholecystectomy(LC), and to summarize the experience of operation. Methods Perioperative clinical data of 25 consecutive with LC combined with LSG procedures performed from Aug. 2015 to Nov.2016 in Department of Hepatobiliary Surgery, Affiliated Hospital of North Sichuan Medical College were retrospective analyzed. Preoperative, postoperative and perioperative data were collected. All patients were followed up for 6 months, with statistical follow-up data. Results LC combined with LSG was successfully performed in 25 patients. There was no biliary fistula, biliary tract injury, gastric fistula, abdominal bleeding and other obvious complications. The patient′s body weight was decreased from(88.3±11.6)kg to (61.1 ± 10.5)kg, BMI decreased from 34.5 ± 5.7 to 23.4 ± 0.9. The blood lipids levels from preoperative (12.4 ± 8.5)mmol/L down to (2.1 ± 0.8)mmol/L in 18 hyperlipidemia patients; The fasting blood glucose levels from preoperative (13.1 ± 1.6) mmol / L down to (5.8 ± 1.0)mmol/L in 6 patients with type 2 diabetes; and blood pressure decreased from (164 ± 14) / (102 ± 8) mmHg to (135 ± 11.2 )/ (91 ± 6.9)mmHg in 7 patients with hypertension. Conclusions The LC combined with LSG is a safe and feasible operation for patients with acute calculous cholecystitis and obesity. The therapeutic effect of gallbladder disease, weight loss and metabolic disease is similar to that of LC or LSG alone. In clinical practice, doctors need to provide a comprehensive surgical options for such patients. Key words: Cholecystitis; Gallstones; Sleeve gastrectomy; Weight loss; Metabolic disease