Clinicopathologic differences before and after elective laparoscopic cholecystectomy according to obesity

Abstract

BACKGROUND

Although obesity is a well-established contributor to surgical risks, evidence regarding the specific outcomes of laparoscopic cholecystectomy (LC) in obese patients remains scarce.

AIM

To assess clinicopathologic differences and 1-year outcomes following elective LC in patients with obesity and gallstone disease.

METHODS

This retrospective study analyzed data from 65 patients who underwent elective LC for gallstone disease between January 2020 and May 2022, with outcomes assessed at the 1-year follow-up. Patients were categorized as obese (body mass index ≥ 25 kg/m²) or non-obese (body mass index < 25 kg/m²), and comparisons were made across preoperative laboratory values, intraoperative parameters, and patient-reported outcomes.

RESULTS

The obese group had significantly higher American Society of Anesthesiologists scores, higher glycated hemoglobin levels, and lower vitamin D levels than the non-obese group. Elevated triglycerides were more frequent in the obese group, whereas higher high-density lipoprotein levels were more common in the non-obese group. Intraoperative and postoperative outcomes did not differ between the groups. At the 1-year follow-up, 24.6% of patients reported post-cholecystectomy symptoms, with no group differences.

CONCLUSION

Obese patients had higher American Society of Anesthesiologists scores, lower vitamin D, and elevated triglycerides preoperatively, but these differences did not significantly affect intraoperative findings or 1-year postoperative outcomes compared to non-obese patients.

Keywords: Obesity; Body mass index; Laparoscopic cholecystectomy; Preoperative care; Patient outcome assessment

Core Tip: This study investigated the impact of obesity on the clinical characteristics and outcomes of patients undergoing elective laparoscopic cholecystectomy for gallstone disease. Obese patients showed distinct preoperative features, including higher American Society of Anesthesiologists scores, elevated glycated hemoglobin levels, and lower vitamin D levels; however, surgical outcomes were similar to those of non-obese patients. Postoperative care should focus on addressing obesity-related risks to improve long-term outcomes even when immediate surgical results are unaffected.