P-129 Necessity and safety of simultaneous cholecystectomy during gastric surgery in patients with asymptomatic cholelithiasis: A systematic review and meta-analysis

Gastric surgery has been associated with an increased risk of cholelithiasis. While prophylactic cholecystectomy may not be necessary for patients with intact gallbladders, the value of simultaneous cholecystectomy for those with asymptomatic gallstones is unclear. We conducted a systematic review and meta-analysis to evaluate the incidence of symptomatic cholelithiasis and complications after simultaneous cholecystectomy in patients with asymptomatic cholelithiasis following gastric surgery. PubMed, Embase and the Cochrane Library were searched for relevant articles published from database inception until March 10, 2022. Meta-analysis was used to evaluated the incidence of symptomatic cholelithiasis and complications of surgery. Patients with asymptomatic cholelithiasis after gastric surgery were more likely to develop symptomatic cholelithiasis than those without cholelithiasis (RR 2.28 [95% CI 1.23, 4.25]) or with unknown gallbladder conditions (RR 2.70 [95% CI 1.54, 4.73]). The risk of symptomatic cholelithiasis did not significantly differ between patients without cholelithiasis and those with unknown gallbladder conditions (RR 0.74 [95% CI 0.37, 1.50]). Furthermore, patients who underwent simultaneous cholecystectomy did not have a higher risk of complications compared to those who underwent only gastric surgery (RR 0.86 [95% CI 0.48, 1.53]). Simultaneous cholecystectomy is necessary and safe for patients with asymptomatic cholelithiasis undergoing gastric surgery. Screening for gallbladder conditions before gastric surgery is also necessary, but if the patient's gallbladder condition is not known, simultaneous cholecystectomy should not be performed.