Toms Augustin1, Maitham A Moslim2, Stacy Brethauer3, Ali Aminian4, Matthew Kroh5, Eric Schneider6, R Matthew Walsh7. 1. Department of General Surgery, Digestive Disease and Surgery Institute, Cleveland Clinic, 9500 Euclid Avenue, Cleveland, OH, USA. Electronic address: augustt@ccf.org. 2. Department of General Surgery, Digestive Disease and Surgery Institute, Cleveland Clinic, 9500 Euclid Avenue, Cleveland, OH, USA. Electronic address: moslimm@ccf.org. 3. Department of General Surgery, Digestive Disease and Surgery Institute, Cleveland Clinic, 9500 Euclid Avenue, Cleveland, OH, USA. Electronic address: brethas@ccf.org. 4. Department of General Surgery, Digestive Disease and Surgery Institute, Cleveland Clinic, 9500 Euclid Avenue, Cleveland, OH, USA. Electronic address: aminiaa@ccf.org. 5. Department of General Surgery, Digestive Disease and Surgery Institute, Cleveland Clinic, 9500 Euclid Avenue, Cleveland, OH, USA. Electronic address: krohm@ccf.org. 6. Brigham and Women's Hospital, Harvard Medical School, Department of Surgery, 75 Francis St, Boston, MA, USA. Electronic address: eschnei1@jhmi.edu. 7. Department of General Surgery, Digestive Disease and Surgery Institute, Cleveland Clinic, 9500 Euclid Avenue, Cleveland, OH, USA. Electronic address: walshm@ccf.org.
Abstract
BACKGROUND: The risks from super obesity (SO) following cholecystectomy have not been studied. METHODS: NSQIP analysis of patients undergoing cholecystectomy from 2005 to 2011. Non-obese (NO) patients (BMI 18.5-30) were matched 1:1 by age, sex, race and comorbidities to morbidly obese (MO) (BMI 35-50), and separately to SO (BMI≥50) individuals. Clavien 4 complications and 30-day mortality were compared. RESULTS: 13780 MO and 1410 SO patients were matched to NO patients. Obese patients were more likely to present with chronic (CC) rather than acute cholecystitis (AC). Compared to NO patients, Clavien 4 complications were significantly increased among SO patients overall especially with AC where rate of open surgery was significantly higher. CONCLUSION: SO patients have an increased risk of serious morbidity after cholecystectomy especially with AC where rate of open surgery remains high. Aggressive recommendation for cholecystectomy to reduce presentation with AC and increase likelihood for laparoscopic surgery may be beneficial in SO patients.
BACKGROUND: The risks from super obesity (SO) following cholecystectomy have not been studied. METHODS: NSQIP analysis of patients undergoing cholecystectomy from 2005 to 2011. Non-obese (NO) patients (BMI 18.5-30) were matched 1:1 by age, sex, race and comorbidities to morbidly obese (MO) (BMI 35-50), and separately to SO (BMI≥50) individuals. Clavien 4 complications and 30-day mortality were compared. RESULTS: 13780 MO and 1410 SO patients were matched to NO patients. Obesepatients were more likely to present with chronic (CC) rather than acute cholecystitis (AC). Compared to NO patients, Clavien 4 complications were significantly increased among SO patients overall especially with AC where rate of open surgery was significantly higher. CONCLUSION: SO patients have an increased risk of serious morbidity after cholecystectomy especially with AC where rate of open surgery remains high. Aggressive recommendation for cholecystectomy to reduce presentation with AC and increase likelihood for laparoscopic surgery may be beneficial in SO patients.
Authors: Danny Lee; Ryan Lee; Safa C Fassihi; Monica Stadecker; Jessica H Heyer; Seth Stake; Kyla Rakoczy; Thomas Rodenhouse; Rajeev Pandarinath Journal: Iowa Orthop J Date: 2022-06
Authors: Taylor D Ottesen; Alp Yurter; Blake N Shultz; Anoop R Galivanche; Cheryl K Zogg; Patawut Bovonratwet; Lee E Rubin; Jonathan N Grauer Journal: J Am Acad Orthop Surg Glob Res Rev Date: 2019-08-06