Sinnamon AJ, et al. - This study focused on prophylactic cholecystectomy at time of surgery for small bowel neuroendocrine tumor (SBNET) in terms of it's adoption or associated morbidity. There appeared no higher morbidity or mortality with the adoption of this practice yet it is performed in a minority of patients. Prospective study seemed necessary to assess which patients could derive benefit from this approach.

Methods

• Researchers searched the American College of Surgeons National Surgical Quality Improvement Program database (2008–2014) to assess patients who underwent SBNET resection.
• With multivariable adjustment for confounders, the risk differences of morbidity and mortality associated with performance of concurrent cholecystectomy were determined.

Results

• There were 1300 patients who underwent SBNET resection; 144 of these (11.1%) underwent concurrent cholecystectomy.
• Patients undergoing cholecystectomy had median age of 62 years [interquartile range (IQR) 52–69 years], and among them 75 were male.
• Disseminated cancer (36.1 vs. 11.6%, p < 0.001) or SBNET located in duodenum (10.4 vs. 4.9%, p = 0.045) were more frequent among patients undergoing cholecystectomy; in other baseline characteristics, there appeared no difference.
• Significantly longer operative time was observed in the cholecystectomy group (median 172 vs. 123 min, p < 0.001).
• There appeared no significant difference regarding rate of postoperative morbidity between cholecystectomy and no-cholecystectomy groups (11.8 vs. 11.1%, p = 0.79).
• The risk difference of morbidity attributable to cholecystectomy, after adjustment for confounding, was + 0.4% [95% confidence interval (CI) - 4.9 to + 5.6%].
• Between cholecystectomy and no-cholecystectomy groups, no significant difference was evident regarding mortality within 30 days (1.4 vs. 0.6%, p = 0.29).