Thesis (M.Sc.) - Cairo University - Faculty of Medicine - Department of General Surgery

Background: Nowadays obesity is one of the most important health problems. Morbid obesity is defined as when the body mass index exceeds 40 kg/m². Obesity is an independent risk factor for gallstones. In obese patients, gallstone is more symptomatic than in non-obese people. Bariatric procedures have been accelerating with simultaneous cholecystectomy application nowadays. However, the routine application of prophylactic cholecystectomy in patients with obesity surgery with gallstone has been discussed in previous literatures. Prophylactic cholecystectomy has come onto the agenda due to adhesions that may occur after past surgery, but currently it is not routinely accepted. Cholecystectomy is recommended in symptomatic patients Methods: A prospective single arm clinical trial including 48 obese patients presenting in bariatric clinic in Cairo university hospitals. Proper history was taken and investigations including abdominal ultrasound (US) were done to include the patients with gall stone disease whether symptomatic or not. The presence of preoperative gastroesophageal reflux disease (GERD) symptoms is assessed using Reflux symptom Index (RSI). All patients underwent concomitant laparoscopic sleeve gastrectomy and cholecystectomy and the clinical outcome of the procedure was evaluated in terms of postoperative complications including leakage whether gastric or biliary, bleeding, jaundice, and surgical site infection (SSI), operative time and postoperative stay. A 1 month postoperative RefluxSymptom Index score is compared to that collected preoperatively

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