The impact of body mass index on laparoscopic cholecystectomy in Taiwan: an oriental experience.
OBJECTIVE
The outcome analysis of obese patients undergoing laparoscopic cholecystectomy (LC) in Asia-Pacific countries is rarely reported. This study examined associations between body mass index (BMI) and clinical outcomes of elective LC in Taiwan.


METHODS
A total of 627 patients with gallbladder disease due to gallstones undergoing LC were divided into three groups based on BMI: <25.0 kg/m2 (normal, NO; n = 310), 25.0-29.9 kg/m2 (overweight, OW; n = 252), and >30 kg/m2 (obese, OB; n = 65).


RESULTS
Both overweight and obesity were not associated with conversion and complication rates. The conversion rates of the three groups were 5.5 (NO), 6.0 (OW), and 4.6% (OB), and the complication rates were 3.2 (NO), 2.4% (OW), and 4.6% (OB), respectively. However, overweight and obesity were related to a trend toward longer operating time (NO 67.4 +/- 31.8; OW 77.8 +/- 35.6; OB 79.0 +/- 37.9 min) (P trend <0.001). One death (BMI 40.6 kg/m2) was due to septic complications. In the multivariable logistic analysis, only acute cholecystitis, but not BMI, was a predictor for conversion and complications.


CONCLUSIONS
Based on these results, it appears that BMI was not associated with clinical outcomes and that LC is a safe procedure in obese patients with uncomplicated gallstone disease in Taiwan.
Chang
Wen-Tsan
WT
Division of Hepatobiliarypancreatic Surgery, Department of Surgery, Kaohsiung Medical University Hospital, 100, Tz-You 1st Road, Kaohsiung, 80756, Taiwan.
Lee
King-Teh
KT
Huang
Meng-Chuan
MC
Chen
Jong-Shyone
JS
Chiang
Hung-Che
HC
Kuo
Kung-Kai
KK
Chuang
Shin-Chang
SC
Wang
Sen-Ren
SR
Ker
Chen-Guo
CG
D000328:Adult; D000368:Aged; D000704:Analysis of Variance; D015992:Body Mass Index; D002760:Cholangiopancreatography, Endoscopic Retrograde; D017081:Cholecystectomy, Laparoscopic / Q000379:methods* / Q000401:mortality; D002769:Cholelithiasis / Q000150:complications / Q000175:diagnosis / Q000601:surgery*; D015331:Cohort Studies; D016001:Confidence Intervals; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D007813:Laparotomy / Q000379:methods; D007902:Length of Stay; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009765:Obesity / Q000150:complications; D011183:Postoperative Complications / Q000453:epidemiology*; D011300:Preoperative Care / Q000379:methods; D011336:Probability; D012189:Retrospective Studies; D018570:Risk Assessment; D015996:Survival Rate; D013624:Taiwan; D013997:Time Factors; D016896:Treatment Outcome; D018608:Ultrasonography, Doppler