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Impact of obesity on surgical outcome after single-incision laparoscopic cholecystectomy

INTRODUCTION: Single-incision laparoscopic cholecystectomy (SILC) is widely used as a treatment option for gallbladder disease. However, obesity has been considered a relative contraindication to this approach due to more advanced technical difficulties. The aim of this report was to review our expe...

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Autores principales: Obuchi, Toru, Kameyama, Noriaki, Tomita, Masato, Mitsuhashi, Hiroaki, Miyata, Ryohei, Baba, Shigeaki
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Medknow Publications & Media Pvt Ltd 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5869987/
https://www.ncbi.nlm.nih.gov/pubmed/28695876
http://dx.doi.org/10.4103/jmas.JMAS_13_17
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author Obuchi, Toru
Kameyama, Noriaki
Tomita, Masato
Mitsuhashi, Hiroaki
Miyata, Ryohei
Baba, Shigeaki
author_facet Obuchi, Toru
Kameyama, Noriaki
Tomita, Masato
Mitsuhashi, Hiroaki
Miyata, Ryohei
Baba, Shigeaki
author_sort Obuchi, Toru
collection PubMed
description INTRODUCTION: Single-incision laparoscopic cholecystectomy (SILC) is widely used as a treatment option for gallbladder disease. However, obesity has been considered a relative contraindication to this approach due to more advanced technical difficulties. The aim of this report was to review our experience with SILC to evaluate the impact of body mass index (BMI) on the surgical outcome. PATIENTS AND METHODS: Between May 2009 and February 2013, 237 patients underwent SILC at our institute. Pre- and post-operative data of the 17 obese patients (O-group) (BMI ≥30 kg/m(2)) and 220 non-obese patients (NO-group) (BMI <29.9 kg/m(2)) were compared retrospectively. SILC was performed under general anaesthesia, using glove technique. Indications for surgery included benign gallbladder disease, except for emergent surgeries. RESULTS: Mean age of patients was significantly higher in the NO-group than O-group (58.9 ± 13.5 years vs. 50.8 ± 14.0 years, P = 0.025). SILC was successfully completed in 233 patients (98.3%). Four patients (1.7%) in the NO-group required an additional port, and one patient was converted to an open procedure. The median operative time was 70 ± 25 min in the NO-group and 75.2 ± 18.3 min in the O-group. All complications were minor, except for one case in the NO-group that suffered with leakage of the cystic duct stump, for which endoscopic nasobiliary drainage was need. CONCLUSION: Our findings show that obesity, intended as a BMI ≥30 kg/m(2), does not have an adverse impact on the technical difficulty and post-operative outcomes of SILC. Obesity-related comorbidities did not increase the risks for SILC.
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spelling pubmed-58699872018-04-05 Impact of obesity on surgical outcome after single-incision laparoscopic cholecystectomy Obuchi, Toru Kameyama, Noriaki Tomita, Masato Mitsuhashi, Hiroaki Miyata, Ryohei Baba, Shigeaki J Minim Access Surg Original Article INTRODUCTION: Single-incision laparoscopic cholecystectomy (SILC) is widely used as a treatment option for gallbladder disease. However, obesity has been considered a relative contraindication to this approach due to more advanced technical difficulties. The aim of this report was to review our experience with SILC to evaluate the impact of body mass index (BMI) on the surgical outcome. PATIENTS AND METHODS: Between May 2009 and February 2013, 237 patients underwent SILC at our institute. Pre- and post-operative data of the 17 obese patients (O-group) (BMI ≥30 kg/m(2)) and 220 non-obese patients (NO-group) (BMI <29.9 kg/m(2)) were compared retrospectively. SILC was performed under general anaesthesia, using glove technique. Indications for surgery included benign gallbladder disease, except for emergent surgeries. RESULTS: Mean age of patients was significantly higher in the NO-group than O-group (58.9 ± 13.5 years vs. 50.8 ± 14.0 years, P = 0.025). SILC was successfully completed in 233 patients (98.3%). Four patients (1.7%) in the NO-group required an additional port, and one patient was converted to an open procedure. The median operative time was 70 ± 25 min in the NO-group and 75.2 ± 18.3 min in the O-group. All complications were minor, except for one case in the NO-group that suffered with leakage of the cystic duct stump, for which endoscopic nasobiliary drainage was need. CONCLUSION: Our findings show that obesity, intended as a BMI ≥30 kg/m(2), does not have an adverse impact on the technical difficulty and post-operative outcomes of SILC. Obesity-related comorbidities did not increase the risks for SILC. Medknow Publications & Media Pvt Ltd 2018 /pmc/articles/PMC5869987/ /pubmed/28695876 http://dx.doi.org/10.4103/jmas.JMAS_13_17 Text en Copyright: © 2017 Journal of Minimal Access Surgery http://creativecommons.org/licenses/by-nc-sa/3.0 This is an open access article distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 3.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as the author is credited and the new creations are licensed under the identical terms.
spellingShingle Original Article
Obuchi, Toru
Kameyama, Noriaki
Tomita, Masato
Mitsuhashi, Hiroaki
Miyata, Ryohei
Baba, Shigeaki
Impact of obesity on surgical outcome after single-incision laparoscopic cholecystectomy
title Impact of obesity on surgical outcome after single-incision laparoscopic cholecystectomy
title_full Impact of obesity on surgical outcome after single-incision laparoscopic cholecystectomy
title_fullStr Impact of obesity on surgical outcome after single-incision laparoscopic cholecystectomy
title_full_unstemmed Impact of obesity on surgical outcome after single-incision laparoscopic cholecystectomy
title_short Impact of obesity on surgical outcome after single-incision laparoscopic cholecystectomy
title_sort impact of obesity on surgical outcome after single-incision laparoscopic cholecystectomy
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5869987/
https://www.ncbi.nlm.nih.gov/pubmed/28695876
http://dx.doi.org/10.4103/jmas.JMAS_13_17
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