Highlights
- •A retrospective review of robotic cholecystectomy (RC) in obese patients.
- •Clinical outcomes of 617 RC were collected and analyzed.
- •Outcomes were comparable to laparoscopic literature on obese patients.
- •Higher BMI classes and complicated gallbladders were associated with complications.
Abstract
Background
As obese adults often suffer from gallbladder disease, more data on postoperative
outcomes following robotic cholecystectomy(RC) is needed.
Methods
RC candidates with a body mass index(BMI) > 30 kg/m2 were included. Postoperative course was documented and analyzed. A logistic regression
analysis was performed to determine possible risk factors associated with complications.
Results
617 patients with a BMI of 35.9 ± 6.4 kg/m2 were included of which 65 had complicated gallbladders (gangrenous, fistulated, or
abscessed). Eight cases were converted to open. Sixty-five(10.5%) patients revisited
the emergency department within 30 days, and 35(5.7%) were readmitted to the hospital.
Average follow-up time was 35 months. Fifty(9.1%) patients experienced complications,
eight(1.5%) underwent reoperation. Postoperative complications were associated with
chronic obstructive pulmonary disease[p < 0.001, Odds-Ratio(OR):8.418, 95%-Confidence-interval(CI):4.029–17.585],
BMI(p < 0.024, OR:1.045, 95%-CI:[1.006–1.086]), class-III obesity (p < 0.021, OR:2.221,
95%-CI:[1.126–4.379], and complicated gallbladders (p < 0.001, OR:3.659, 95%CI:[1.665–8.041]).
Conclusion
This is the first study to establish a link between higher obesity classes and postoperative
complications following RC.
Keywords
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Article info
Publication history
Published online: March 09, 2023
Accepted:
March 8,
2023
Received in revised form:
February 15,
2023
Received:
January 25,
2023
Publication stage
In Press Journal Pre-ProofIdentification
Copyright
© 2023 Elsevier Inc. All rights reserved.
