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BT08
OBESITY AND ACUTE CHOLECYSTITIS
Author(s) -
Yeung S.
Publication year - 2009
Publication title -
anz journal of surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.426
H-Index - 70
eISSN - 1445-2197
pISSN - 1445-1433
DOI - 10.1111/j.1445-2197.2009.04912_8.x
Subject(s) - medicine , pneumoperitoneum , cholecystitis , steatosis , cholecystectomy , laparoscopic cholecystectomy , general surgery , incidence (geometry) , gallstones , obesity , gallbladder , dissection (medical) , gallbladder disease , surgery , gastroenterology , laparoscopy , physics , optics
Obesity has been well recognised for its association with gallbladder disease. In bariatric surgical series, the incidence of cholelithiasis in morbidly obese patients approaches 87–97%. 1 When compared to an equivalent group of non‐obese patients, patients with a BMI 45 kg/m 2 had a five to seven‐fold increase risk of development of cholelithiasis. 1,2 Cholecystitis and cholesterolosis of the gallbladder are also more frequent in obese patients. 1 Multiple studies of laparoscopic cholecystectomy (LC) in obese patients have demonstrated no significant difference in operating times, conversion rates or post‐operative morbidity. 3,4 In other series, there is a trend towards increased operating times and failure to perform intraoperative cholangiography. 5 LC in obese patients is a more demanding procedure. The technical issues are related to exposure and safe dissection of Calot's triangle, potential problems with the pneumoperitoneum, hepatic steatosis, and the abundant abdominal wall and intraperitoneal fat. Techniques to overcome these difficulties will be discussed.