Analysis of Intraoperative Complications and Outcomes Associated With Obesity During Elective Laparoscopic Cholecystectomy.

Abstract

As obesity becomes more common, understanding its risks in routine operations is increasingly important. This study assessed the impact of obesity on intraoperative complications during elective laparoscopic cholecystectomy. Retrospective data on elective laparoscopic cholecystectomies across a single metropolitan health network were collected from July 2021-June 2023. Patients were stratified into WHO-defined obesity classes. Intraoperative complication (measured by ClassIntra classification), intraoperative and postoperative outcomes were compared. There were 713 patients included. Intraoperative complications graded as ClassIntra 1 and 2 were 11.0% and 6.1% for non-overweight patients and rose to 35.3% and 13.2% respectively for class III obesity (p < 0.001). Increasing obesity class was independently associated with higher intraoperative complication severity, with a 2.59-fold increase in the odds of a more severe complication category per class increase (p < 0.001). Obesity was associated with increased operative duration (p = 0.006) but did not increase the risk of postoperative morbidity (p = 0.88). Obesity significantly increases the risks of intraoperative complications in patients undergoing elective cholecystectomy, as measured by the ClassIntra classification, and contributes to increased operative duration. Despite this, postoperative morbidity remains low with no significant difference in length of stay, complications or readmissions across obesity classes.