Bariatric Surgery With or Without Concomitant Laparoscopic Cholecystectomy in Morbidly Obese Patients With Gallbladder Stone Disease: A Prospective Randomized Controlled Pilot Study.

Introduction: Imagine a surgeon's critical decision: Should the gallbladder be removed now, along with the planned bariatric surgery, or risk the complication and necessity of a second surgery later? This clinical dilemma is central to treating morbidly obese patients, who face a high prevalence of gallstone disease exacerbated by rapid postoperative weight loss. The best approach to managing existing gallstones in bariatric candidates remains debated, with debate focusing on whether combining laparoscopic cholecystectomy (LC) with bariatric surgery is both safe and advantageous. In this pilot study, we provide randomized evidence to guide this decision. Methods: In this prospective randomized controlled pilot study, 58 morbidly obese patients with ultrasound-confirmed gallstones were randomly assigned to two groups: Group I ( Results: Baseline demographics and comorbidities were similar across groups. Operative time was longer in Group I (98.93 ± 11.58 min) than in Group II (75.18 ± 11.26 min, Conclusion: Concomitant LC during bariatric surgery in morbidly obese patients with pre-existing gallstones is demonstrated to be safe and feasible, with acceptable increases in operative time and postoperative pain. The high rate (79.3%) of symptomatic gallstone development in patients who did not undergo concomitant cholecystectomy supports adopting routine concomitant LC to prevent future morbidity, thereby influencing clinical decision-making and standard practice.