Skip to main content Skip to main navigation menu Skip to site footer

A systematic review and meta-analysis of the impact of obesity on postoperative outcomes for patients undergoing laparoscopic cholecystectomy


Introduction: Laparoscopic cholecystectomy may reduce post-operative complications in the majority of patients, but it remains a challenge for obesity patients. We aimed to examine the postoperative outcome in obese patients undergoing laparoscopic cholecystectomy.

Method: Each author conducted a search form PubMed, EuropePMC, and Sciencedirect databases from on 30 November 2022. According to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses we conducted this study. All types of studies, laparoscopy cholecystectomy in obese patients, English papers, older than 18 years old were included in these studies. Abstract only articles, no fully published English papers were excluded from this study.

Results: Nine publications including 7138 patients from 1999 to 2022 were identified. Compared with normal weight patients, adult obese patient had higher conversion rates (P=0.002), blood loss (P=0.009), intraoperative complication (P=0.08), postoperative complication (P=0.04), mortality (P=0.45), longer need of surgical time (P<0.00001). No significance difference in length of stay were found (P=0.98).

Conclusion: This study found that laparoscopic cholecystectomy for obese patients has a higher conversion rates, the need of longer surgical time, and blood loss compared to normal weight individual. Intraoperative, postoperative complication, and mortality were found but not statically significance. Further prospective studies are required to maximize outcome.


  1. Schönbeck Y, Talma H, van Dommelen P, et al. Increase in Prevalence of Overweight in Dutch Children and Adolescents: A Comparison of Nationwide Growth Studies in 1980, 1997 and 2009. PLoS One. 2011;6:e27608.
  2. Abdelaal M, le Roux CW, Docherty NG. Morbidity and mortality associated with obesity. Ann Transl Med. 2017;5:161.
  3. Reshetnyak VI. Concept of the pathogenesis and treatment of cholelithiasis. World J Hepatol. 2012;4:18–34.
  4. Hruby A, Hu FB. The Epidemiology of Obesity: A Big Picture. Pharmacoeconomics. 2015;33:673–89.
  5. Coccolini F, Catena F, Pisano M, et al. Open versus laparoscopic cholecystectomy in acute cholecystitis. Systematic review and meta-analysis. Int J Surg. 2015;18:196–204.
  6. Page MJ, McKenzie JE, Bossuyt PM, et al. The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. BMJ. 2021;372:1–9.
  7. Ammori BJ, Vezakis A, Davides D, et al. Laparoscopic cholecystectomy in morbidly obese patients. Surg Endosc. 2001;15:1336–9.
  8. Afaneh C, Abelson J, Rich BS, et al. Obesity does not increase morbidity of laparoscopic cholecystectomy. J Surg Res. 2014;190:491–7.
  9. Raakow J, Klein D, Barutcu AG, et al. Safety and Efficiency of Single-Incision Laparoscopic Cholecystectomy in Obese Patients: A Case-Matched Comparative Analysis. J Laparoendosc Adv Surg Tech A. 2019;29:1005–1010.
  10. Gregori M, Miccini M, Biacchi D, et al. Day case laparoscopic cholecystectomy: Safety and feasibility in obese patients. Int J Surg. 2018;49:22–26.
  11. Farkas DT, Moradi D, Moaddel D, et al. The impact of body mass index on outcomes after laparoscopic cholecystectomy. Surg Endosc. 2012;26:964–9.
  12. Chang WT, Lee KT, Huang MC, et al. The impact of body mass index on laparoscopic cholecystectomy in Taiwan: an oriental experience. J Hepatobiliary Pancreat Surg 2009;16:648–54.
  13. Paajanen H, Käkelä P, Suuronen S, et al. Impact of obesity and associated diseases on outcome after laparoscopic cholecystectomy. Surg Laparosc Endosc Percutan Tech. 2012;22:509–13.
  14. Gatsoulis N, Koulas S, Kiparos G, et al. Laparoscopic cholecystectomy in obese and nonobese patients. Obes Surg. 1999;9:459–61.
  15. Lauro A, Vaccari S, Cervellera M, et al. Laparoscopic cholecystectomy for acute cholecystitis: are intended operative approach, timing and outcome affected by BMI? A multicenter retrospective study. Il Giornale di Chirurgia-Journal of the Italian Surgical Association. 2018;39(2):87-91.
  16. Tripathi M, Kaushik S, Dubey P. The effect of use of pyridostigmine and requirement of vecuronium in patients with myasthenia gravis. Journal of postgraduate medicine. 2003;49(4):311.

How to Cite

Natalia Maria Christina, & Wijaya, J. H. (2023). A systematic review and meta-analysis of the impact of obesity on postoperative outcomes for patients undergoing laparoscopic cholecystectomy. Bali Medical Journal, 12(1), 946–953.




Search Panel

Natalia Maria Christina
Google Scholar
BMJ Journal

Jeremiah Hilkiah Wijaya
Google Scholar
BMJ Journal