In-Hospital Outcomes of Robotic-Assisted Cholecystectomy in Obese versus Normal-Weight Patients: A National Inpatient Sample Analysis.

INTRODUCTION

Obesity increases perioperative risks in cholecystectomy due to its association with gallbladder disease. Robotic-assisted cholecystectomy (RC) may mitigate technical challenges in this population. This study compares in-hospital outcomes of RC between obese (BMI ≥30 kg/m2) and normal-weight (BMI 18-25 kg/m2) patients using National Inpatient Sample data.

METHODS

A retrospective analysis of National Inpatient Sample data (2016-2021) identified 15,048 adults undergoing RC. Patients were stratified into obese (n = 4570) and normal-weight (n = 10,478) groups. Demographics, comorbidities, hospital characteristics, and in-hospital outcomes were analyzed using multivariable models.

RESULTS

Thirty percent of RC patients were obese. Obese individuals were younger than normal-weight patients (median 50 versus 57 y, P < 0.001) and had lower mortality (adjusted OR 0.27, 95% CI 0.10-0.60, P = 0.004) and infection rates (adjusted OR 0.33, 95% CI 0.09-0.89, P = 0.05), with no significant differences in other complications or open conversion.

CONCLUSIONS

RC is increasingly performed in obese patients and appears safe in appropriately selected individuals. Despite higher comorbidity burdens, obese patients demonstrated lower in-hospital mortality and similar complication rates. Potential selection bias and lack of long-term outcome data warrant cautious interpretation.