The impact of body mass index on outcomes after laparoscopic cholecystectomy

Abstract

Increased BMI was not associated with worse outcomes after LC. Compared with normal weight patients, obese and even morbidly obese patients have no increased risk of conversion to open surgery, nor is there an increased risk of perioperative complications. Obese and morbidly obese patients who require a cholecystectomy should be considered in the same category as normal weight patients, and LC should be the standard of care.

Acute cholecystitis: risk factors for conversion to an open procedure

“…Increased BMI was also independently associated with CTO. Although the current literature is divided as to whether BMI is predictive of conversion [4,6,8,9,15], possible explanations that support this finding include increased difficulty with liver retraction, increased pneumoperitoneum requirements, and difficult laparoscopic instrument placement and manipulation given the increased abdominal wall thickness. Increased preoperative alkaline phosphatase and WBC and decreased albumin were also predictive of CTO.…”

Does obesity affect the outcomes of pulmonary resections for lung cancer? A National Surgical Quality Improvement Program analysis

“…4,12 Although several authors have described worse outcomes in obese patients after procedures such as colectomy and adrenalectomy, other studies have shown no differences related to BMI in outcomes for procedures such as esophagectomy and cholecystectomy. [13][14][15][16][17] Although it might be a common assumption that obesity represents a major risk factor for poor operative outcomes, there are studies reporting that not only this paradigm may be false, but also that overweight and moderate obesity might even be associated with improved early operative outcomes. 12,18 There is no clear explanation for this protective effect, which has been described as the ''obesity paradox,'' and is observed not only after surgery, but also in critically ill, hospitalized patients.…”

Laparoscopic cholecystectomy: consensus conference-based guidelines

“…Comparative data suggest that obesity, even morbid obesity (BMI>40), does not result in an increase in morbidity, mortality, and conversion rates when compared to the nonobese population [47][48][49][50][51][52][53][54][55] (LE 3). Instead Rosen [48] and Chandio [49] found BMI as a predicting factor of conversion in acute cholecystitis.…”