Simultaneous Laparoscopic Cholecystectomy and Gynecologic Surgery: A Narrative Review of Indications, Technique, and Outcomes

Gallstone disease and benign or premalignant gynecologic disease frequently coexist in women, and both are routinely treated by laparoscopy. Combining laparoscopic cholecystectomy and gynecologic surgery in a single session avoids a second anesthetic episode and hospitalization, but it raises questions about patient selection, technique, and safety. This narrative review summarizes the evidence on concomitant laparoscopic cholecystectomy and gynecologic procedures, distinguishing direct evidence from mixed cohorts. In a population-based study of more than 1.7 million women undergoing outpatient laparoscopic cholecystectomy, concurrent gynecologic procedures, mainly adnexal surgery and conization, were not associated with significantly higher morbidity (adjusted odds ratio 1.39, 95% confidence interval 0.75–2.59), although this wide interval does not establish equivalent safety. Institutional series report low major complication rates, but evidence specifically supporting combined hysterectomy is limited to case reports and small series. In contrast, evidence from bariatric surgery shows that adding cholecystectomy to procedures with an anastomosis increases complications, so the safety of a combination depends on the index operation. We describe the authors’ preferred, adaptable workflow covering indications, risk assessment, team organization, port placement, sequence of procedures, and specimen extraction. Combined surgery is feasible in selected patients, with reassuring reported outcomes, although comparative safety remains uncertain; prospective registries with standardized outcome reporting are needed.