Clinicopathologic differences before and after elective laparoscopic cholecystectomy according to obesity

Area of Science:

• Gastroenterology
• Bariatric Surgery
• Surgical Outcomes

Background:

• Obesity is a known surgical risk factor, yet specific outcomes for laparoscopic cholecystectomy (LC) in obese patients are not well-documented.
• Gallstone disease is common and often treated with LC.

Purpose of the Study:

• To compare clinicopathologic differences and 1-year outcomes of elective LC in obese versus non-obese patients with gallstone disease.

Main Methods:

• Retrospective analysis of 65 patients undergoing elective LC for gallstone disease (Jan 2020 - May 2022).
• Patients were classified as obese (BMI ≥ 25 kg/m²) or non-obese (BMI < 25 kg/m²).
• Comparison of preoperative labs, intraoperative parameters, and 1-year patient-reported outcomes.

Main Results:

• Obese patients had higher American Society of Anesthesiologists (ASA) scores, glycated hemoglobin, and lower vitamin D levels.
• Elevated triglycerides were more frequent in obese patients; higher HDL was more common in non-obese.
• No significant differences in intraoperative or postoperative outcomes between groups.
• 24.6% of all patients reported post-cholecystectomy symptoms at 1 year, with no group difference.

Conclusions:

• Obese patients present with distinct preoperative metabolic profiles (e.g., lower vitamin D, higher triglycerides) and higher ASA scores.
• These preoperative differences did not translate to altered intraoperative findings or 1-year postoperative outcomes after LC.
• Laparoscopic cholecystectomy appears safe and effective for gallstone disease in obese patients, with outcomes comparable to non-obese individuals.