title: Day case laparoscopic cholecystectomy in patients with high BMI: Experience from a UK centre.
abstract: BACKGROUND
  Symptomatic gall stones may require laparoscopic cholecystectomy (LC), which is one of the most commonly performed general surgical operations in the western world. Patients with a high body mass index (BMI) are at increased risk of having gall stones, and are often considered at high risk of surgical complications due to their increased BMI. We believe that day case surgery could nevertheless have significant benefits in terms of potential cost savings and patient satisfaction in this population. We therefore compared the outcomes of day case patients undergoing LC stratified by BMI, with a specific focus on the safety and success of the procedure in obese and morbidly obese groups.
  
  
  METHODS
  We reviewed a database of day case procedures performed between January 2004 and December 2012, including all patients with symptomatic gall stone disease who underwent LC. The patients were divided in four BMI groups: less than 25 kg/m(2), 25-29 kg/m(2), 30-39 kg/m(2) and 40 kg/m(2) or above.
  
  
  RESULTS
  The overall success rate for day case surgery was 78%. There were no significant differences in rates of intra-abdominal collection or readmission with increasing BMI. However, increasing BMI was associated with a significant increase in the rate of wound infection.
  
  
  CONCLUSIONS
  LC in patients with a high BMI is safe and can be performed effectively as a day case procedure.
authors.affiliation: Aintree University Hospital , Liverpool , UK.
authors.forename: A
authors.initials: A
authors.lastname: Tandon
authors.affiliation: Aintree University Hospital , Liverpool , UK.
authors.forename: G
authors.initials: G
authors.lastname: Sunderland
authors.affiliation: Aintree University Hospital , Liverpool , UK.|Royal Liverpool & Broadgreen University Hospitals NHS Trust , UK.
authors.forename: Q M
authors.initials: QM
authors.lastname: Nunes
authors.affiliation: Aintree University Hospital , Liverpool , UK.
authors.forename: N
authors.initials: N
authors.lastname: Misra
authors.affiliation: Aintree University Hospital , Liverpool , UK.
authors.forename: M
authors.initials: M
authors.lastname: Shrotri
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000556:Ambulatory Surgical Procedures / Q000009:adverse effects / Q000706:statistics & numerical data*; D015992:Body Mass Index; D017081:Cholecystectomy, Laparoscopic / Q000009:adverse effects* / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000150:complications* / Q000453:epidemiology; D011183:Postoperative Complications / Q000453:epidemiology*; D012189:Retrospective Studies; D006113:United Kingdom / Q000453:epidemiology; D055815:Young Adult
keywords: Body mass index; Complications; Day case; Laparoscopic cholecystectomy