Safety and feasibility of single-incision laparoscopic cholecystectomy in obese patients.

Wakasugi, Masaki; Tanemura, Masahiro; Tei, Mitsuyoshi; Furukawa, Kenta; Suzuki, Yozo; Masuzawa, Toru; Kishi, Kentaro; Akamatsu, Hiroki

BACKGROUND Current literature frequently indicates that experienced laparoscopic surgeons can safely perform single-incision laparoscopic cholecystectomy, but there have been few reports evaluating the feasibility and safety of performing single-incision laparoscopic cholecystectomy for obese patients. Therefore, a large single-center database was retrospectively reviewed to evaluate the feasibility and safety of single-incision laparoscopic cholecystectomy for obese patients by comparing the outcomes of normal-weight and obese patients undergoing single-incision laparoscopic cholecystectomy. METHODS A retrospective analysis of 608 patients undergoing SILC between May 2009 and May 2015 at Osaka Police Hospital was performed, and the outcomes of obese [body mass index (BMI) ≥ 30 kg/m2] and normal-weight patients (18.5 ≤ BMI < 25 kg/m2) were compared. RESULTS Thirty-eight obese patients (mean BMI 32.5 kg/m2) were compared to 362 normal-weight patients (mean BMI 22.0 kg/m2). The American Society of Anesthesiologists (ASA) scores of the obese patients were significantly higher than those of normal-weight patients. The mean operative times in the normal-weight and the obese groups were 110 min vs. 127 min, respectively (p < 0.05). There were no significant differences in the bleeding volume and the conversion rate to a different operative procedure. Perioperative complications were seen in 6% (23/362) of the patients in the normal-weight group and 8% (3/38) of the patients in the obese group (p = 0.7). The mean postoperative hospital stay was 4.5 days for the normal-weight group and 4.4 days for the obese group (p = 0.8). CONCLUSIONS Single-incision laparoscopic cholecystectomy, which offers good cosmetic outcomes, seems feasible and safe in obese patients.