SAFETY AND FEASIBILITY OF THE THREE PORT TECHNIQUE FOR CONCOMITANT CHOLECYSTECTOMY DURING SLEEVE GASTRECTOMY: A COMPREHENSIVE ANALYSIS AND CLINICAL IMPLICATIONS

Introduction:Obesity, a prevalent global health issue, has led to an increased demand for bariatric surgeries, with laparoscopic sleeve gastrectomy (LSG) being a preferred option due to its efficacy and minimal invasiveness. Concomitant cholecystectomy (CC) during LSG has gained traction among patients with obesity and gallstones. While various techniques have been explored, concerns persist regarding safety and efficacy. Our study aims to evaluate the feasibility and outcomes of a three-port laparoscopic technique for this combined procedure. Methodology:Ahigh-volume bariatric center in Saudi Arabia conducted a retrospective cohort study involving patients who underwent three-port sleeve gastrectomy (3PSG) with CC between January 2022 and January 2024. We collected and analyzed data on demographics, preoperative evaluation, intraoperative details, and postoperative outcomes using descriptive statistics. Results:Out of 360 LSG patients, 76 underwent CC with the three-port technique. The mean age was 42.18 years, with a female predominance (71.0%) and a mean BMI of 44.67 kg/m2. Intraoperatively, the mean operative time was 109.8 minutes, with minimal blood loss and no complications or conversions to open surgery. The average hospital stay was 2.1 days. Postoperatively, the complication rate was 4%, primarily consisting of early bleeding, port-site infection, and atelectasis, all of which were managed conservatively. No severe complications, mortalities, or thrombotic events occurred during the 3-month follow-up. Conclusion:Thethree-port laparoscopic technique for concomitant cholecystectomy during sleeve gastrectomy appears safe and feasible, offering favorable outcomes in terms of operative time, blood loss, and postoperative complications. This approach presents a promising option for minimizing surgical trauma and enhancing recovery in obese patients who require both procedures.