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“For patients with symptomatic gallstones and obesity (i.e., considering both cholecystectomy and gastric bypass), cholecystectomy should preferentially be performed before gastric bypass,” said 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 elyze 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. Among people who had both procedures, roughly 13% had complications regardless of which operation came first or second. When gallbladder operations were done after weight-loss surgery, however, almost 16% of patients had complications, compared with 8% of patients when the gallbladder operation was done first. Even though the study doesn’t explain why complication rates differed, the results suggest that it makes sense for patients to discuss the ideal order of both operations with doctors before they have surgery, said Dr.
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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