Obesity and its influence on liver dysfunction, morbidity and mortality after liver resection.

Autor:	Kampf S; Division of Visceral Surgery, Department of General Surgery, Medical University of Vienna, Vienna, Austria., Sponder M; Division of Cardiology, Department of Internal Medicine II, Medical University of Vienna, Vienna, Austria., Fitschek F; Division of Visceral Surgery, Department of General Surgery, Medical University of Vienna, Vienna, Austria., Laxar D; Division of Visceral Surgery, Department of General Surgery, Medical University of Vienna, Vienna, Austria., Bodingbauer M; Division of Visceral Surgery, Department of General Surgery, Medical University of Vienna, Vienna, Austria., Binder C; Clinical Institute of Pathology, Medical University of Vienna, Vienna, Austria., Stremitzer S; Division of Visceral Surgery, Department of General Surgery, Medical University of Vienna, Vienna, Austria., Kaczirek K; Division of Visceral Surgery, Department of General Surgery, Medical University of Vienna, Vienna, Austria., Schwarz C; Division of Visceral Surgery, Department of General Surgery, Medical University of Vienna, Vienna, Austria.
Jazyk:	angličtina
Zdroj:	Hepatobiliary surgery and nutrition [Hepatobiliary Surg Nutr] 2023 Oct 01; Vol. 12 (5), pp. 704-714. Date of Electronic Publication: 2023 Apr 03.
DOI:	10.21037/hbsn-22-291
Abstrakt:	Background: Obesity and associated steatosis is an increasing health problem worldwide. Its influence on post-hepatectomy liver failure (PHLF) and after liver resection (LR) is still unclear. Methods: Patients who underwent LR were investigated and divided into three groups [normal weight: body mass index (BMI) 18.5-24.9 kg/m 2 , overweight: BMI 25.0-29.9 kg/m 2 , obese: BMI ≥30 kg/m 2 ] in this retrospective study. Primary aim of this study was to assess the influence of BMI and nonalcoholic steatohepatitis (NASH) on PHLF and morbidity. Results: Of 888 included patients, 361 (40.7%) had normal weight, 360 (40.5%) were overweight, 167 (18.8%) were obese. Median age was 62.5 years (IQR, 54-69 years). The primary indication for LR was colorectal liver metastases (CLM) (n=366, 41.2%). NASH was present in 58 (16.1%) of normal weight, 84 (23.3%) of overweight and 69 (41.3%) of obese patients (P<0.001). PHLF occurred in 16.3% in normal weight, 15.3% in overweight and 11.4% in obese patients (P=0.32). NASH was not associated with PHLF. There was no association between patients' weight and the occurrence of postoperative complications (P=0.45). At multivariable analysis, solely major LR [odds ratio (OR): 2.7, 95% confidence interval (CI): 1.83-4.04; P<0.001] remained a significant predictor for PHLF. Conclusions: Postoperative complications and PHLF are comparable in normal weight, overweight and obese patients and LRs using modern techniques can be safely performed in these patients. Competing Interests: Conflicts of Interest: All authors have completed the ICMJE uniform disclosure form (available at https://hbsn.amegroups.com/article/view/10.21037/hbsn-22-291/coif). The authors have no conflicts of interest to declare. (2023 Hepatobiliary Surgery and Nutrition. All rights reserved.)
Databáze:	MEDLINE
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