부산대학교 도서관

Abstract: Background or Purpose: Weight loss is associated with a fivefold increase in gallstone formation and management of common bile duct stones by conventional endoscopic is challenging after laparoscopic Roux-en-Y gastric bypass. The primary aim of this systematic review and meta-analysis is to evaluate the role of prophylactic cholecystectomy in these patients with gallbladder pathology.Methods: Studies were searched and selected based on predefined inclusion and exclusion criteria from database and manual search. The published articles in Medline, Embase, Cochrane central database, and PubMed central between January 1997 and December 2020 are included. Data were analysed using the Newcastle Ottawa score for quality and Revman software for the meta-analysis.Results: A total of ten observational studies with 5658 patients were appraised. Cholecystectomy was performed in 27.14% of cases. Of these, 13.15% underwent cholecystectomy before and 8.89% had concomitant with after laparoscopic Roux-en-Y gastric bypass. Newly detected gallbladder pathology on ultrasound scan was 9.09% after laparoscopic Roux-en-Y gastric bypass & 18.63% remained asymptomatic and only 5.11% required cholecystectomy.Conclusion: There is no substantial evidence to support prophylactic cholecystectomy in patients undergoing laparoscopic Roux-en-Y gastric bypass for weight loss. Structured and well-powered RCTs need to be done to provide quality evidence.