Abstract

POZO, F.; GIGANTO, F.  and  RODRIGO, L.. Non-complicated cholelithiasis associated with GERD: Results of combined laparoscopic surgery in low risk patients. Rev. esp. enferm. dig. [online]. 2004, vol.96, n.4, pp.237-245. ISSN 1130-0108.

Objectives: the aim of this study was to evaluate the efficacy of combined laparoscopic surgery for non-complicated cholelithiasis and gastroesophageal reflux disease (GERD) in patients with low surgical risk. Methods: a total of 680 cholecystectomies performed by means of laparoscopic surgery were retrospectively studied from February 1991 to February 2002. A total of 442 patients that fulfilled the inclusion criteria were divided into two groups: group A: non-complicated cholelithiasis (cholecystectomy alone), consisting of a total of 362 patients, and group B: non-complicated cholelithiasis and GERD (cholecystectomy and Toupet’s fundoplication in all cases) in 80 patients. Demographic and clinical data, intraoperatory incidences, and post-surgical complications were prospectively collected and compared for all patients. The results of reflux surgery (group B) were evaluated at 6 months by means of 24-hour pH-metry. Results: in spite of the fact that the group undergoing combined surgery consisted of patients with greater weight and older age (p < 0.05), no significant differences were found in the number of intraoperative incidences and post-surgical complications between both groups (NS). Significant differences were only found in the duration of surgery: 48 ± 25 min (10-150) in group A compared to 112 ± 23 min (80-180) in group B (p<0.001), and in the return to normal daily activities (5.8 ± 0.9 days vs 6.5 ± 1 days in group B) (p< 0.001). In the latter group a normalization of 24-hour pH-metry values and an absence of symptoms associated with reflux were observed in all cases. Conclusions: in patients younger than 75 years with low surgical risk and non-complicated cholelithiasis and GERD, both illnesses can be resolved during the same surgical procedure by laparoscopy with no increased risk or postoperative complications.

Keywords : Laparoscopic cholecystectomy; Gastroesophageal reflux; Toupet’s fundoplication; Endoscopic surgery.

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