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Cholecystectomy After Previous Bariatric Surgery with Special Focus on Pregnant Patients—Results from Two Large Nationwide Registries

Hedström, Jonas LU ; Nilsson, Johan LU ; Ekelund, Mikael LU ; Andersson, Roland LU and Andersson, Bodil LU (2020) In Obesity Surgery
Abstract

Background: Biliary complications during pregnancy is an important issue. The aim of this study was to examine if there is an increased risk to perform cholecystectomy during pregnancy in patients with previous bariatric surgery in comparison to other females subjected to cholecystectomy. Methods: The Nationwide Swedish Registry for Gallstone Surgery (GallRiks) and the Scandinavian Obesity Surgery Registry (SOReg) were combined. Female patients 18–45 years old were included. The study group was patients with a history of bariatric surgery whom were pregnant at the time of cholecystectomy. This group was compared with pregnant patients without previous bariatric surgery and non-pregnant with and without previous bariatric surgery.... (More)

Background: Biliary complications during pregnancy is an important issue. The aim of this study was to examine if there is an increased risk to perform cholecystectomy during pregnancy in patients with previous bariatric surgery in comparison to other females subjected to cholecystectomy. Methods: The Nationwide Swedish Registry for Gallstone Surgery (GallRiks) and the Scandinavian Obesity Surgery Registry (SOReg) were combined. Female patients 18–45 years old were included. The study group was patients with a history of bariatric surgery whom were pregnant at the time of cholecystectomy. This group was compared with pregnant patients without previous bariatric surgery and non-pregnant with and without previous bariatric surgery. Results: In total, 21,314 patients were included and 292 underwent surgery during pregnancy. From 1282 patients identified in both registers, 16 patients were pregnant at the time of cholecystectomy. Acute cholecystectomy was performed in 5922 (28%) non-pregnant and 199 (68%) pregnant (p < 0.001), including 11/16 (69%) pregnant with previous bariatric surgery. When comparing all pregnant patients, those with previous bariatric surgery had longer operative time (p = 0.031) and length of stay (p = 0.043), but no differences were seen when only comparing patients with an acute indication for surgery. There was no difference in complications comparing pregnant patients with previous bariatric surgery with non-pregnant, both with and without previous bariatric surgery. Conclusions: Cholecystectomy during pregnancy in patients with previous bariatric surgery seems to be safe. The increased risk seen in the non-pregnant group after previous bariatric surgery is not seen in pregnancy, possibly due to an optimization of the circumstances at surgery.

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author
organization
publishing date
type
Contribution to journal
publication status
epub
subject
keywords
Bariatric surgery, Cholecystectomy, Complications, Gallstone disease, Pregnancy
in
Obesity Surgery
publisher
Springer
external identifiers
  • scopus:85078333056
  • pmid:31981044
ISSN
0960-8923
DOI
10.1007/s11695-020-04409-3
language
English
LU publication?
yes
id
18057bd8-8adf-480d-8576-2f2c30a3c016
date added to LUP
2020-02-10 09:42:35
date last changed
2020-03-16 10:56:06
@article{18057bd8-8adf-480d-8576-2f2c30a3c016,
  abstract     = {<p>Background: Biliary complications during pregnancy is an important issue. The aim of this study was to examine if there is an increased risk to perform cholecystectomy during pregnancy in patients with previous bariatric surgery in comparison to other females subjected to cholecystectomy. Methods: The Nationwide Swedish Registry for Gallstone Surgery (GallRiks) and the Scandinavian Obesity Surgery Registry (SOReg) were combined. Female patients 18–45 years old were included. The study group was patients with a history of bariatric surgery whom were pregnant at the time of cholecystectomy. This group was compared with pregnant patients without previous bariatric surgery and non-pregnant with and without previous bariatric surgery. Results: In total, 21,314 patients were included and 292 underwent surgery during pregnancy. From 1282 patients identified in both registers, 16 patients were pregnant at the time of cholecystectomy. Acute cholecystectomy was performed in 5922 (28%) non-pregnant and 199 (68%) pregnant (p &lt; 0.001), including 11/16 (69%) pregnant with previous bariatric surgery. When comparing all pregnant patients, those with previous bariatric surgery had longer operative time (p = 0.031) and length of stay (p = 0.043), but no differences were seen when only comparing patients with an acute indication for surgery. There was no difference in complications comparing pregnant patients with previous bariatric surgery with non-pregnant, both with and without previous bariatric surgery. Conclusions: Cholecystectomy during pregnancy in patients with previous bariatric surgery seems to be safe. The increased risk seen in the non-pregnant group after previous bariatric surgery is not seen in pregnancy, possibly due to an optimization of the circumstances at surgery.</p>},
  author       = {Hedström, Jonas and Nilsson, Johan and Ekelund, Mikael and Andersson, Roland and Andersson, Bodil},
  issn         = {0960-8923},
  language     = {eng},
  month        = {01},
  publisher    = {Springer},
  series       = {Obesity Surgery},
  title        = {Cholecystectomy After Previous Bariatric Surgery with Special Focus on Pregnant Patients—Results from Two Large Nationwide Registries},
  url          = {http://dx.doi.org/10.1007/s11695-020-04409-3},
  doi          = {10.1007/s11695-020-04409-3},
  year         = {2020},
}