Liver resection in obese patients: Results of a case-control study

Luca Viganò, Michael D. Kluger, Alexis Laurent, Claude Tayar, Jean Claude Merle, Jean Yves Lauzet, Marion Andreoletti, Daniel Cherqui

Research output: Contribution to journalArticlepeer-review

Abstract

Objectives: Obesity has been associated with worse postoperative outcomes. No data are available regarding short-term results after liver resection (LR). The aim of this study was to analyse outcomes in obese patients (body mass index [BMI] > 30 kg/m2) undergoing LR. Methods: 85 consecutive obese patients undergoing LR between 1998 and 2008 were matched on a ratio of 1:2 with 170 non-obese patients. Matching criteria were diagnosis, ASA score, METAVIR fibrosis score, extent of LR, and Child-Pugh score in patients with cirrhosis. Results: Operative time, blood loss and blood transfusions were similar in the two groups. Mortality was 2.4% in both groups. Morbidity was significantly higher in the obese group (32.9% vs. 21.2%; P= 0.041). However, only grade II morbidity was increased in obese patients (14.1% vs. 1.8%; P <0.001) and this was mainly related to abdominal wall complications (8.2% vs. 2.4%; P= 0.046). No differences were encountered in terms of grade III or IV morbidity. The same results were observed in major LR and cirrhotic patients. When patients were stratified by BMI (30 kg/m2), progressive increases in overall and infectious morbidity were observed (5.6%, 22.4%, 23.7%, 32.9%, and 5.6%, 11.8%, 14.5%, 18.8%, respectively). Rates of grade III and IV morbidity did not change. Discussion: Obese patients have increased postoperative morbidity after LR in comparison with non-obese patients, but this is mainly related to minor abdominal wall complications. Severe morbidity rates and mortality are similar to those in non-obese patients, even in cirrhosis or after major LR.

Original languageEnglish
Pages (from-to)103-111
Number of pages9
JournalHPB
Volume13
Issue number2
DOIs
Publication statusPublished - Feb 2011

Keywords

  • ASA score
  • BMI
  • case-control study
  • cirrhosis
  • laparoscopic liver surgery
  • liver resection
  • liver surgery
  • morbidity
  • obesity
  • postoperative outcomes
  • steatosis

ASJC Scopus subject areas

  • Gastroenterology
  • Hepatology

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