Obesity and mid-term outcomes following robotic cholecystectomy.

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.