袖状切除术+胆囊切除术

Sleeve gastrectomy is the procedure of choice in the vast majority of patients requiring "primary" weight loss surgery. It is also not very infrequent to encounter a patient with symptomatic gallbladder stones while being prepared for a sleeve procedure. Therefore concomitant cholecystectomies are also frequently being done during sleeves. Our preferred approach is as follows:
1- Do the sleeve first & the cholecystectomy last
2- Leave very small antrum behind.
3- Try to leave "no" fundus behind
4- Excise the fundic fat pad
5- İnvert the upper corner of the staple line with purse string technique
6- Reinforce all staple line with continuous "full-thickness" suturing
7- Take care about the "critical view of safety" during the removal of the gallbladder to avoid biliary injuries.

                               
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