Abstract
A 27-year-old-man, who was a morbidly obese man, with a body mass index (BMI) of 41 kg/m2, came to our institute with epigastric pain. MRI showed swelling and wall thickness of gall bladder with stones. Laparoscopic chlecystectomy was performed successfully 4 weeks after percutaneous transhepatic gall bladder drainage. Postoperative coarse was uneventful and the patient was discharged on the second postoperative day. In the operation of an extremely obese patient, laparoscopic surgery was more useful than laparotomy. However, there are numerous problems such as preparation of operative bed or stools, preventing from deep vein thrombus or decubitus, and translation of the patient from the operation bed to the ICU bed. Also extreme obesity is responsible for difficulty of tracheal intubation, intraoperative hypoxicemia and hypotension. All stuffs including surgeons, anesthetists and nurses should discuss preoperatively about the management during operation and make a detailed plan of the operative care.
