gms | German Medical Science

133. Kongress der Deutschen Gesellschaft für Chirurgie

Deutsche Gesellschaft für Chirurgie

26.04. - 29.04.2016, Berlin

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Is Hybrid-NOTES cholecystectomy feasible in morbidly obese patients? – A short-term comparison with patients of normal weight

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  • Dirk Rolf Bulian - Krankenhaus Köln-Merheim, Klinik für Viszeral-, Gefäß- und Transplantationschirurgie, Köln, Deutschland
  • Anna Rieger - Klinikum der Universität Witten/Herdecke; Campus Merheim; Kliniken der Stadt Köln, Klinik für Viszeral-, Gefäß- und Transplantationschirurgie, Köln, Deutschland
  • Jürgen Knuth - Klinikum Kempten-Oberallgäu, Klinik für Allgemein-, Viszeral-, Gefäß- und Thoraxchirurgie, Kempten, Deutschland
  • Jürgen Meyer - Klinikum der Universität Witten/Herdecke; Campus Merheim; Kliniken der Stadt Köln, Klinik für Viszeral-, Gefäß- und Transplantationschirurgie, Köln, Deutschland
  • Markus Maria Heiss - Klinikum der Universität Witten/Herdecke; Campus Merheim; Kliniken der Stadt Köln, Klinik für Viszeral-, Gefäß- und Transplantationschirurgie, Köln, Deutschland

Deutsche Gesellschaft für Chirurgie. 133. Kongress der Deutschen Gesellschaft für Chirurgie. Berlin, 26.-29.04.2016. Düsseldorf: German Medical Science GMS Publishing House; 2016. Doc16dgch063

doi: 10.3205/16dgch063, urn:nbn:de:0183-16dgch0639

Veröffentlicht: 21. April 2016

© 2016 Bulian et al.
Dieser Artikel ist ein Open-Access-Artikel und steht unter den Lizenzbedingungen der Creative Commons Attribution 4.0 License (Namensnennung). Lizenz-Angaben siehe http://creativecommons.org/licenses/by/4.0/.

Gliederung

Text

Background: Several studies have found advantages for Transvaginal Hybrid-NOTES-Cholecystectomy (TVC) when compared to traditional laparoscopic cholecystectomy. Obesity is a risk factor for cholecystolithiasis, but simultaneously it is considered as an exclusion criterion in many studies. Thus, a separate evaluation of this patient-group is essential.

Materials and methods: From the 197 TVC of the NOTES-Database of our clinic, the 16 morbidly obese patients (BMI ≥ 40.0 kg/m2; MOP) were compared to the 59 normal weight patients (BMI 18.5–24.9 kg/m2; NWP) concerning patient- and procedure-related parameters as well as the rate of complications and conversions.

Results: Median procedural time was significantly longer for MOP as compared to NWP (76.5 minutes [41-159] vs. 51.0 minutes [31-140]; p=0.001). For MOP, application of more than one percutaneous trocar was necessary significantly more often (43.8% vs. 5.1%; p<0.001), in one case, closure of the transvaginal access was impossible due to obesity. While there were no conversions or intraoperative complications, there were 4 postoperative complications in the NWP group (6.8%), but without a significant difference between the two groups (p=0.572). The postoperative hospital stay did not differ significantly, either (2 days [2-6] vs. 2 days [1-7]; p=0.814).

Conclusion: Although TVC seems to be more difficult in the morbidly obese, our analysis found no disadvantage in terms of conversion-rate, complication-rate or length of hospital stay.