A Novel Four-port-sharing Approach for Concomitant Cholecystectomy With Laparoscopic Sleeve Gastrectomy

Background: Gallbladder disease is very common in obese patients. Concomitant cholecystectomy with laparoscopic sleeve gastrectomy (CC-LSG) may be necessary in such cases, and it has been proven safe when indicated. Herein, we developed a novel four-port-sharing technique for CC-LSG that can substitute the conventional trocar placement (6–7 ports). Methods: A retrospective cohort study was conducted between January 2017 and March 2021 using a prospective database. Out of 159 patients who underwent LSG, 10 also received CC-LSG. The patients’ demographic characteristics, intraoperative outcomes, and postoperative outcomes were examined. Results: Of a total of 159 patients, 18 had cholelithiasis (11.3%). Eight symptomatic and 2 asymptomatic patients (6 men and 4 women) with cholelithiasis underwent CC-LSG. No postoperative complications, including hemorrhage, bile leakage, staple leakage, incisional hernia, and wound infection, were noted. Conclusions: In CC-LSG, the application of a four-port-sharing technique is safe and feasible, and it provides satisfying cosmetic outcomes for obese patients with symptomatic or asymptomatic cholelithiasis.