ABSTRACT
Introduction: The increasing prevalence of obesity worldwide has raised concerns about its impact on surgical outcomes across various procedures. Laparoscopic cholecystectomy (LC), a common surgical intervention for benign gallbladder disease, is no exception. The relationship between obesity and LC outcomes remains complex and merits further investigation. Aim: This retrospective study aimed to assess the influence of obesity on the safety and surgical outcomes of LC. Material and methods: Patients were divided into 2 groups: those with obesity (body mass index (BMI) ≥ 30 kg/m²) and non-obese controls (BMI < 30 kg/m²). Baseline characteristics, operative duration, hospitalization length, and post-operative complications, categorized by the Clavien-Dindo classification, were evaluated. Results: Among 116 patients with obesity and 176 non-obese controls, differences in age and gender were noted but were not clinically significant. Operative time was longer in the group with obesity. Hospitalization length and adverse event occurrence did not differ significantly. Importantly, post-operative complications showed no substantial differences between the groups, suggesting that obesity may not significantly increase the complication risk in this population. Conclusions: Obesity may not substantially elevate the risk of adverse events or severe complications following LC in this patient population. Careful patient selection, preoperative evaluation, and surgical technique remain crucial. Further research in larger, diverse populations is needed to validate these findings.
ABSTRACT
Introduction: Laparoscopic sleeve gastrectomy (LSG) has gained prominence as a therapeutic option for obesity and metabolic diseases. The choice of staple line reinforcement technique in LSG remains a subject of debate, particularly concerning postoperative bleeding complications. Aim: The aim of this retrospective analysis is to assess the influence of different staple line reinforcement techniques on the occurrence of bleeding complications LSG. Material and methods: We conducted a retrospective analysis of patients undergoing LSG between September 2021 and April 2023 at our institution. Patients were stratified into two groups based on the staple line reinforcement method: continuous suturing (n = 53) and clipping (n = 28). Surgical outcomes, including operative time, length of hospital stay, and bleeding complications, were assessed. Complications were classified using the Clavien-Dindo classification. Results: Continuous suturing was associated with a significantly longer operative time (88.15 min vs. 74.64 min, p < 0.05) but a similar length of hospital stay. Notably, no bleeding complications occurred in the continuous suturing group, while the clipping group experienced postoperative bleeding in 7.14% of cases (p < 0.05). Continuous suturing exhibited a slightly higher incidence of minor complications classified as Class I in the Clavien-Dindo classification (7.55% vs. 0%). Conclusions: This retrospective analysis suggests that continuous suturing may provide enhanced hemostasis along the staple line, reducing the risk of postoperative bleeding compared to clipping. Despite the longer operative time and a slightly higher rate of minor complications, the clinical significance of these findings should be considered within the context of individual patient risk profiles.
