Laparoscopic cholecystectomy in morbidly obese patients.
BACKGROUND
Morbid obesity is generally regarded as a risk factor for laparoscopic cholecystectomy due to increases in operative time, morbidity, and conversion rate to open cholecystectomy. The aim of this study was to evaluate the feasibility and outcome of laparoscopic cholecystectomy (LC) in morbidly obese patients.


METHODS
A total of 864 consecutive patients underwent LC at our institution between 1990 and 1997. This series represents a continuing policy of LC for all comers. Data were collected prospectively. There were 659 nonobese (NO: BMI 40 kg/m2). Laparoscopic bile duct exploration was performed in 28 (4.2%), nine (4.8%), and one (5.9%) patients, respectively.


RESULTS
Obesity and morbid obesity were associated with trends toward an increased conversion rate (2.3% NO; 4.3% OB; 5.9% MO), a longer operative time (median, 80, 85, and 107 mins, respectively), greater postoperative morbidity (4.7%, 5.9%, and 11.8%, respectively), and a reduced ability to obtain cholangiography (86.1%, 80.1%, and 71.4%, respectively). None of these differences, however, were statistically significant (c2 test, p > 0.05). Postoperative hospital stay for LC was similar for all three groups (median, 1 day).


CONCLUSIONS
LC in morbidly obese patients is a safe procedure, but it may be associated with increased operative difficulty and morbidity, as compared with nonobese and obese patients.
Ammori
B J
BJ
Leeds Institute for Minimally Invasive Therapy (LIMIT), University Department of Surgery, The General Infirmary, Great George Street, Leeds LS1 3EX, England.
Vezakis
A
A
Davides
D
D
Martin
I G
IG
Larvin
M
M
McMahon
M J
MJ
D000328:Adult; D001646:Bile; D001652:Bile Ducts / Q000293:injuries; D017081:Cholecystectomy, Laparoscopic / Q000009:adverse effects / Q000379:methods*; D005240:Feasibility Studies; D005260:Female; D005705:Gallbladder Diseases / Q000150:complications / Q000601:surgery; D006801:Humans; D008297:Male; D008875:Middle Aged; D009767:Obesity, Morbid / Q000150:complications*; D012086:Reoperation; D016896:Treatment Outcome