The impact of obesity in patients undergoing laparoscopic cholecystectomy.

Abstract

Objective: To evaluate the effect of obesity on operative duration and the rate of conversion to open surgery among patients undergoing laparoscopic cholecystectomy. Study Design: Analytical Cross-sectional study. Setting: Department of Surgery. Period: 25 November 2025 to 24 May 2026. Methods: Recruitment was concluded after the required sample size of 194 patients had been achieved. A total of 194 patients scheduled for laparoscopic cholecystectomy were included and categorized into two equal groups: obese (n=97) and non-obese (n=97). The sample size was determined using the WHO sample size calculator with a confidence level of 95% and study power of 90%. Patients aged between 18 and 60 years, of either gender, were selected through simple random sampling. Baseline demographic and clinical characteristics including age, sex, body mass index (BMI), ASA classification, associated comorbidities, and history of prior abdominal surgery were documented. All procedures were performed by consultant surgeons having a minimum of three years’ post-fellowship experience. The primary outcomes assessed were operative time and frequency of conversion to open cholecystectomy. Statistical analysis was carried out using SPSS version 25. Independent sample t-test and Chi-square test were used for comparison, with p≤0.05 taken as statistically significant. Results: Obese patients demonstrated a longer mean operative time compared to non-obese patients (97.43 ± 35.04 minutes vs. 87.45 ± 35.75 minutes); however, this difference did not reach statistical significance (p=0.051). The rate of conversion to open cholecystectomy was significantly greater in the obese group than in the non-obese group (14.4% vs. 3.1%; p=0.005). Subgroup analysis further revealed increased conversion rates among obese individuals in several categories, particularly females, younger patients, those with higher ASA grades, and patients with diabetes mellitus or hypertension. Conclusion: Obesity appears to increase the likelihood of conversion from laparoscopic to open cholecystectomy and may also contribute to prolonged operative duration. Thorough preoperative evaluation, appropriate patient counseling, and experienced surgical management are important factors in achieving favorable outcomes in obese patients undergoing laparoscopic cholecystectomy.