Duodenal switch without versus with laparoscopic cholecystectomy: a perioperative risk comparative analysis of the MBSAQIP database (2015–2019)

• Published in: Surgical endoscopy Vol. 37; no. 1; pp. 219 - 224
• Main Authors: Clapp, Ben, Janik, Michal, Corbett, John, Vahibe, Ahmet, Ul Hassan, Omer, Husain, Farah, Pullat, Rana, Ghanem, Omar M.
• Format: Journal Article
• Language: English
• Published: New York Springer US 2023; Springer Nature B.V
• Subjects: Abdominal Surgery; Aerospace medicine; Age; Biliopancreatic Diversion - methods; Body mass index; Cholecystectomy; Cholecystectomy, Laparoscopic - adverse effects; Comparative analysis; Diabetes; Duodenum - surgery; Endoscopy; Gastrectomy - methods; Gastric Bypass - methods; Gastroenterology; Gastroesophageal reflux; Gastrointestinal surgery; Gynecology; Hepatology; Humans; Laparoscopy; Laparoscopy - methods; Medicine; Medicine & Public Health; Metabolism; Mortality; Obesity, Morbid - surgery; Original Article; Patients; Postoperative Complications - epidemiology; Postoperative Complications - etiology; Postoperative Complications - surgery; Postoperative period; Proctology; Retrospective Studies; Surgery; Cholecystectomy; Reoperation; Duodenal switch; Reintervention; Operative time; Clavien-Dindo complications
• ISSN: 0930-2794; 1432-2218
• DOI: 10.1007/s00464-022-09477-3

Background The results of concurrent cholecystectomy with Roux-en Y gastric bypass and sleeve gastrectomy have been well elucidated. Large-scale data on the outcomes of concomitant cholecystectomy during biliopancreatic diversion with duodenal switch (BPD-DS) are still lacking. Our study aimed to explore whether simultaneous cholecystectomy with BPD-DS alters the 30-day postoperative outcomes. Methods We conducted a retrospective analysis of the MBSAQIP database between 2015 and 2019. Propensity-score matching (PSM) in BPD-DS with cholecystectomy (Group 1) and BPD-DS without cholecystectomy (Group 2) cohorts was performed (PSM ratio 1:2). The two groups were matched for a total of 21 baseline variables including age, gender, BMI, ASA class, and other medical comorbidities and conditions. The 30-day postoperative morbidity, mortality, reoperation, reintervention, and readmissions were obtained. Results Initially, 568 patients in Group 1 and 5079 in Group 2 were identified. After performing PSM, 564 and 1128 patients respectively were compared. The BPD-DS with cholecystectomy group reported a higher rate of reoperation and reintervention compared to BPD-DS alone (3.9% versus 2.4% and 3.2% versus 2%, respectively), even though it did not reach statistical significance. The intervention time was significantly higher in Group 1 compared to Group 2 (192.4 ± 77.6 versus 126.4 ± 61.4 min). Clavien-Dindo complications (1–5) were similar between these two PSM cohorts. Conclusion Concomitant cholecystectomy during BPD-DS increases operative times but does not affect the other outcomes. Based on our results, the decision of cholecystectomy at the time of BPD-DS should be left to the surgeon's judgment.