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J Surg Res. 2014 Aug;190(2):491-7. doi: 10.1016/j.jss.2014.02.014. Epub 2014 Feb 15.

Obesity does not increase morbidity of laparoscopic cholecystectomy.

Author information

  • 1Department of Surgery, New York-Presbyterian Hospital/Weill Cornell Medical Center, New York, New York. Electronic address: cafaneh@gmail.com.
  • 2Department of Surgery, New York-Presbyterian Hospital/Weill Cornell Medical Center, New York, New York.
  • 3Department of Surgery, New York-Presbyterian Hospital/Weill Cornell Medical Center, New York, New York; Department of Public Health, New York-Presbyterian Hospital/Weill Cornell Medical Center, New York, New York.

Abstract

BACKGROUND:

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).

METHODS:

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.

RESULTS:

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.

CONCLUSIONS:

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.

KEYWORDS:

Complication; Conversion; Laparoscopic cholecystectomy; Morbid obesity; Morbidity; Obesity; Outcomes

PMID:
24636101
[PubMed - indexed for MEDLINE]
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