ArticleObesity surgery2026
Surgeons and Experts' Perspectives in Concomitant Bariatric Surgery with Cholecystectomy: Bari-Chole Egypt Survey.
Article in Obesity surgery, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
introductionThe management of gallbladder disease during metabolic and bariatric surgery (MBS) remains controversial. Cholelithiasis is common in patients with obesity, yet the approach to concomitant or prophylactic cholecystectomy varies, with limited data from Egypt. This study aimed to assess Egyptian bariatric surgeons' practices, attitudes, and decision-making regarding cholecystectomy during MBS.
methodsA national cross-sectional survey was distributed to bariatric surgeons in Egypt, collecting information on demographics, surgical experience, preoperative screening, intraoperative decision-making, postoperative management, and prophylactic practices. The questionnaire included structured, closed-ended questions. Data were analyzed descriptively and compared between IFSO members and non-members using chi-square or Fisher's exact tests, with p < 0.05 considered significant.
resultsA total of 117 surgeons participated, predominantly male (99%), with 16.2% IFSO members. Bariatric surgery was concentrated in Cairo (42%) and Alexandria (26%). Most surgeons (97%) screened gallstones preoperatively using abdominal ultrasound. Concomitant cholecystectomy was preferred for documented gallstones by 78%, while 82% never performed prophylactic cholecystectomy in patients with normal gallbladders. The majority performed the bariatric procedure first (82%) in reverse Trendelenburg position (88%), minimizing additional ports. Routine intraoperative cholangiography was rare (1.7%). Postoperative management largely mirrored isolated bariatric surgery, although antibiotic and drain practices differed between groups. Surgeons generally perceived combined procedures as safe, with 76% reporting no increase in complications and 89% reporting similar length of stay.
conclusionEgyptian bariatric surgeons consistently screen for gallstones and favor concomitant cholecystectomy for documented stones, while largely avoiding prophylactic removal of normal gallbladders. Variation exists in intraoperative management and postoperative care. These findings highlight areas for standardization and support the development of a national pathway and multicenter registry to optimize gallbladder management in MBS.
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