Effect of Obesity on Venous Hemodynamics of the Lower Limbs During Laparoscopic Cholecystectomy

Objective: The present study aims to compare the changes of venous flow parameters of the lower limbs under the assessment based on the duplex ultrasound scanning in obese and non-obese individuals by complying with body mass index during laparoscopic cholecystectomy.

Methods: A prospective cohort study was conducted in non-obese (body mass index <25 kg/m) and obese individuals (body mass index >30 kg/m) during laparoscopic cholecystectomy to analyze venous hemodynamics of the lower limbs. The assessment was conducted on Femoral vein diameter, Femoral vein cross-sectional area, Femoral vein peak velocity, and Femoral vein volume flow. The change values (%) of venous flow parameters of the lower limbs were calculated as a percentage by: (intra-operative parameter-pre-operative parameter)/ pre-operative parametersX100%.

Results: 45 right lower limbs were examined in 45 non-obese individuals and 33 right lower limbs in 33 obese individuals during laparoscopic cholecystectomy. The statistically significant difference was identified in the pre-operative and intra-operative values of Femoral vein diameter, Femoral vein cross-sectional area, Femoral vein peak velocity, as well as Femoral vein volume flow in both groups when these were analyzed independently ( = .00). When the change values of venous flow parameters of the lower limbs of the two groups were compared, more changes were identified significantly in the obese group, Femoral vein diameter ( = .042), Femoral vein cross-sectional area ( = .013), Femoral vein peak velocity ( = .002), and Femoral vein volume flow ( = .032).

Conclusion: The changes of lower limb venous flow parameters showed more significant difference in obese than in non-obese individuals during laparoscopic cholecystectomy. The mentioned findings may in part explain why obese patients undergoing laparoscopic cholecystectomy have a higher rate of post op deep venous thrombosis.