Obesity does not increase morbidity of laparoscopic cholecystectomy. Academic Article uri icon

Overview

MeSH

  • Adult
  • Aged
  • Body Mass Index
  • Female
  • Humans
  • Intraoperative Complications
  • Male
  • Middle Aged
  • New York City
  • Postoperative Complications
  • Retrospective Studies

MeSH Major

  • Cholecystectomy, Laparoscopic
  • Gallbladder Diseases
  • Obesity

abstract

  • Obesity has historically been a positive predictor of surgical morbidity, especially in the morbidly obese. The purpose of our study was to compare outcomes of obese patients undergoing laparoscopic cholecystectomy (LC). We reviewed 1382 consecutive patients retrospectively who underwent LC for various pathologies from January 2008 to August 2011. Patients were stratified based on the World Health Organization definitions of obesity: nonobese (body mass index [BMI] < 30 kg/m(2)), obesity class I (BMI 30-34.9 kg/m(2)), obesity class II (BMI 35-39.9 kg/m(2)), and obesity class III (BMI ≥ 40 kg/m(2)). The primary end points were conversion rates and surgical morbidity. The secondary end point was length of stay. There were significantly more females in the obesity II and III groups (P = 0.0002). American Society of Anesthesiologists scores were significantly higher in the obesity I, II, and III groups compared with the nonobese (P < 0.05; P < 0.01; and P < 0.0001, respectively). Independent predictors of conversion on multivariate analysis (MVA) included age (P = 0.01), acute cholecystitis (P = 0.03), operative time (P < 0.0001), blood loss (P < 0.0001), and fellowship-trained surgeons (P < 0.0001). Independent predictors of intraoperative complications on MVA included age (P = 0.009), white patients (P = 0.009), previous surgery (P = 0.001), operative time (P < 0.0001), and blood loss (P = 0.01). Independent predictors of postoperative complications on MVA included American Society of Anesthesiologists score (P < 0.0001), acute cholecystitis (P < 0.0001), and a postoperative complication (P < 0.0001). BMI was not a predictor of conversions or surgical morbidity. Length of stay was not significantly different between the four groups. This study demonstrates that overall conversion rates and surgical morbidity are relatively low following LC, even in obese and morbidly obese patients. Copyright © 2014 Elsevier Inc. All rights reserved.

publication date

  • August 2014

has subject area

  • Adult
  • Aged
  • Body Mass Index
  • Cholecystectomy, Laparoscopic
  • Female
  • Gallbladder Diseases
  • Humans
  • Intraoperative Complications
  • Male
  • Middle Aged
  • New York City
  • Obesity
  • Postoperative Complications
  • Retrospective Studies

Research

keywords

  • Journal Article

Identity

Language

  • eng

Digital Object Identifier (DOI)

  • 10.1016/j.jss.2014.02.014

PubMed ID

  • 24636101

Additional Document Info

start page

  • 491

end page

  • 497

volume

  • 190

number

  • 2