Digestive Disease Center, Showa University Northern Yokohama Hospital, 35-1 Chigasaki-chuo, Tsuzuki-ku, Yokohama, 224-8503, Japan.
Department of Gastrointestinal and General Surgery, Showa University, School of Medicine, 1-5-8, Hatanodai, Shinagawa-ku, Tokyo, 142-8666, Japan.
Sci Rep. 2021 Jan 27;11(1):2384. doi: 10.1038/s41598-021-81963-5.
Obesity is a positive predictor of surgical morbidity. There are few reports of laparoscopic cholecystectomy (LC) outcomes in obese patients. This study aimed to clarify this relationship. This retrospective study included patients who underwent LC at Showa University Northern Yokohama Hospital between January 2017 and April 2020. A total of 563 cases were examined and divided into two groups: obese (n = 142) (BMI ≥ 25 kg/m) and non-obese (n = 241) (BMI < 25 kg/m). The non-obese group had more female patients (54%), whereas the obese group had more male patients (59.1%). The obese group was younger (56.6 years). Preoperative laboratory data of liver function were within the normal range. The obese group had a significantly higher white blood cell (WBC) count (6420/μL), although this was within normal range. Operative time was significantly longer in the obese group (p = 0.0001). However, blood loss and conversion rate were not significantly different among the groups, neither were surgical outcomes, including postoperative hospital stay and complications. Male sex and previous abdominal surgery were risk factors for conversion, and only advanced age (≥ 79 years) was an independent predictor of postoperative complications as observed in the multivariate analysis. Although the operation time was prolonged in obese patients, operative factors and outcomes were not. Therefore, LC could be safely performed in obese patients with similar efficacy as in non-obese patients.
肥胖是手术发病率的一个正向预测因子。肥胖患者行腹腔镜胆囊切除术(LC)的结果鲜有报道。本研究旨在阐明这种关系。
本回顾性研究纳入了 2017 年 1 月至 2020 年 4 月期间在昭和大学横浜北部医院行 LC 的患者。共检查了 563 例患者,并将其分为两组:肥胖组(n = 142)(BMI ≥ 25 kg/m)和非肥胖组(n = 241)(BMI < 25 kg/m)。非肥胖组女性患者更多(54%),而肥胖组男性患者更多(59.1%)。肥胖组更年轻(56.6 岁)。术前肝功能实验室数据均在正常范围内。肥胖组的白细胞(WBC)计数明显更高(6420/μL),尽管这仍在正常范围内。肥胖组的手术时间明显更长(p = 0.0001)。然而,各组间的出血量和中转率无显著差异,包括术后住院时间和并发症也无显著差异。
男性和既往腹部手术是中转的危险因素,只有高龄(≥ 79 岁)是多变量分析中观察到的术后并发症的独立预测因子。尽管肥胖患者的手术时间延长,但手术相关因素和结果并无差异。因此,LC 可安全地用于肥胖患者,其疗效与非肥胖患者相似。