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

INTRODUCTION: ) 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.