Abstract

Introduction: Laparoscopic cholecystectomy (LC) has been proved to be the benchmark
treatment for symptomatic cholelithiasis. The overall morbidity and mortality rate is 5–
10% and 0.1% respectively, and an open conversion rate of 5–10% is commonly
reported in the literature. Over a century, classical cholecystectomy (Open method) has
been the method of choice in the surgical management of gall bladder diseases. One of
the risk factors for cholelithiasis is obesity, the incidence of which is increasing
worldwide due to the change in lifestyle habitat. Therefore, surgeons are likely to
encounter increasing number of obese patients who require a cholecystectomy for
symptomatic cholelithiasis. Conventionally obesity has been considered as a relative
contraindication to LC, as the technical difficulties associated with this procedure in
these patients were thought to be associated with higher morbidity and mortality as well
as increased open conversion rates. The aim of this study was to investigate the safety
[peri-operative morbidity and mortality and the incidence of bile duct injuries (BDI)]
and efficacy (duration of surgery, LOS and open conversion rates) of an elective LC in
the morbid/ super obese patients (BMI > 40) compared to patients with a BMI < 26 and
a BMI 26–40.