67 Benign Biliary Surgery Is Safe in Class II and III Obesity: A Study of Postoperative Outcomes

Abstract Aim Patients with Class II and III obesity (BMI ≥35) are often considered at higher risk of complications after benign biliary surgery, leading to delays or avoidance of intervention. This study assesses whether elevated BMI is truly linked to worse postoperative outcomes. Method A retrospective cohort study was conducted, including all consecutive cholecystectomies performed by two specialist biliary surgeons over 34 months. Patients were stratified into two groups based on BMI: Group-1 (BMI <35.0) and Group-2 (BMI ≥35.0). Postoperative outcomes, including complication rates and length of hospital stay, were compared. Results 319 patients were identified, 237 (74.3%) patients in group-1 and 82 (25.7%) were in group-2.Group-1 (BMI<35.0) n=237Group-2 (BMI≥35.0) n=82P valueMedian Age56 years (IQR 40-66)49 years (36-61)0.013Female142(59.9%)65(75.6%)0.002ASA ≥ 326(11%)18(22%)0.013Emergency Cases90(38%)24(29.3%)0.156Nassar Cholecystectomy Grade 4 & 587(36.7%)25(30.5%)0.309Intra-operative cholangiogram167(70.5%)63(76.8%)0.268Bile duct exploration67(28.3%)25(30.5%)0.702Median post-operative stay (days)1 day (IQR 0-2)1 day (IQR 0-2)0.164Readmission within 30 days13(5.5%)2(2.4%)0.261Complications:Clavien-Dindo 1-210(4.2%)1(1.2%)0.199Clavien-Dindo 3-48(3.4%)00.092Clavien-Dindo 51(0.4%)00.556Need for Level 2 & 3 care5(2.1%)1(1.2%)0.609 Discussion: Operative difficulty and postoperative outcomes are comparable between obese and non-obese patients. Surgeons should not delay intervention in obese individuals, as timely surgery may prevent complications of gallstone disease.