Is Concomitant Cholecystectomy Safe During Laparoscopic Anti-Reflux Surgery?

Abstract

The goal of this study is to prospectively evaluate the safety of concomitant cholecystectomy during laparoscopic anti-reflux surgery (LARS). A total of 1000 patients underwent LARS between May 2004 and August 2009. Patients who had a LARS procedure alone were defined as group A and those who had cholecystectomy during the LARS were defined as group B. All data, including demographics, operative details, perioperative complications, and outcomes, were recorded to the prospective database. Chi-square and t-test were used for statistical analysis. There were 934 (93.4%) patients in group A and 66 (6.6%) in group B. Cholelithiasis (n = 48) and gallbladder polyp larger than 10 mm (n = 18) were the indications for cholecystectomy. Demographic characteristics were similar among the groups. There were no mortality and conversion. The mean operating time was 50 minutes for group A and 80 minutes for group B (P = 0.0001). The mean hospital stay was 1 day for each group. The mean follow-up was 35 and 38 months for groups A and B, respectively (P = 0.195). Esophageal perforation, jejunal perforation, and pulmonary emboli were the major complications and were seen only in group A (P = 0.790). All other peroperative minor complications and postoperative dysphagia, bloating, and reflux recurrence were similar between the two groups (P > 0.05). LARS and cholecystectomy can be performed safely during the same session without increasing the rates of morbidity and recurrence of reflux.