Our Summary

The research paper is about a new surgical method developed in Japan that combines two types of weight loss surgeries - laparoscopic cholecystectomy (LC), which removes the gallbladder, and laparoscopic sleeve gastrectomy (LSG), which reduces the size of the stomach. This combination surgery is not very common in Japan, but the number of such procedures is growing.

The researchers tested this method on 26 obese patients who had gallbladder diseases. They used the same entry points (or ‘ports’) for both surgeries, with one additional port for a liver tool. They first performed the gallbladder removal, and then moved straight to the stomach reduction surgery.

In one unusual case, an extra port was needed due to a patient’s abnormal bile duct. On average, the gallbladder removal part of the surgery took 55 minutes. All patients transitioned smoothly from the first part of the surgery to the second.

One patient experienced internal bleeding after the surgery, but this was managed without further surgical intervention. The researchers concluded that this combined method of surgery is both practical and safe for obese Japanese patients with gallbladder diseases.

FAQs

  1. What is the procedure for performing concomitant laparoscopic cholecystectomy with laparoscopic sleeve gastrectomy in obese Japanese patients?
  2. How safe and feasible is the use of port-sharing techniques in laparoscopic cholecystectomy and laparoscopic sleeve gastrectomy for obese Japanese patients with gall bladder diseases?
  3. What were the complications encountered during the procedure and how were they managed?

Doctor’s Tip

A helpful tip a doctor might tell a patient about laparoscopic cholecystectomy is to follow the post-operative instructions carefully, including taking prescribed pain medication, avoiding heavy lifting, and gradually returning to normal activities as advised by the surgeon. It is important to follow a healthy diet and stay hydrated to support recovery and prevent complications. If any unusual symptoms or complications arise, it is important to contact the surgeon promptly for further evaluation and management.

Suitable For

Patients who are typically recommended for laparoscopic cholecystectomy include those with symptomatic gallstones, acute cholecystitis, chronic cholecystitis, gallbladder polyps, and other gallbladder diseases. Additionally, obese patients who are undergoing bariatric surgery, such as laparoscopic sleeve gastrectomy, may also be recommended for concomitant laparoscopic cholecystectomy to prevent future complications related to gallbladder disease.

Timeline

Before laparoscopic cholecystectomy:

  • Patient experiences symptoms of gallbladder disease such as abdominal pain, nausea, vomiting, and jaundice.
  • Patient undergoes diagnostic tests such as ultrasound or CT scan to confirm the presence of gallstones or other gallbladder issues.
  • Patient may be advised to make dietary changes or take medications to manage symptoms before surgery.

After laparoscopic cholecystectomy:

  • Patient undergoes preoperative preparation including fasting and medication adjustments.
  • Patient is placed under general anesthesia and small incisions are made in the abdomen for the laparoscopic instruments.
  • Surgeon removes the gallbladder using a laparoscope and specialized tools.
  • Patient may experience some pain and discomfort after surgery, but recovery is generally quicker compared to traditional open surgery.
  • Patient is discharged from the hospital within a few days and can resume normal activities within a few weeks.
  • Follow-up appointments are scheduled to monitor recovery and address any complications.

What to Ask Your Doctor

  1. What are the potential risks and benefits of having a laparoscopic cholecystectomy (LC) performed concomitantly with a laparoscopic sleeve gastrectomy (LSG)?

  2. How experienced are you in performing both LC and LSG procedures, especially in a concomitant setting?

  3. What is the typical recovery time and expected outcomes for patients undergoing both procedures simultaneously?

  4. Are there any specific dietary or lifestyle changes I should make before or after the surgeries?

  5. How will the port-sharing technique be utilized during the surgeries, and how does it impact the overall procedure?

  6. Are there any alternative treatment options for my gall bladder disease that I should consider before proceeding with concomitant LC and LSG?

  7. What postoperative care and follow-up appointments should I expect after undergoing both procedures?

  8. How will my weight loss and overall health be monitored and managed following the surgeries?

  9. Are there any additional considerations or precautions I should be aware of due to my specific medical history or conditions?

  10. Can you provide me with information on the success rates and outcomes of patients who have undergone concomitant LC with LSG using the port-sharing techniques you will be utilizing?

Reference

Authors: Ohta M, Tada K, Endo Y, Nakanuma H, Fujinaga A, Kawamura M, Masuda T, Kawasaki T, Watanabe K, Hirashita T, Inomata M. Journal: Surg Today. 2021 Dec;51(12):1996-1999. doi: 10.1007/s00595-021-02304-7. Epub 2021 May 19. PMID: 34009434