Safety and Efficacy of Bariatric Surgery in Cirrhosis Patients With Extreme Obesity
| Autor: | Adil Ghafoor, Naga Chalasani, Leslie M. Schuh, Marshall E. McCabe, Sweta Tandra, Margaret Inman, Siva P. Parcha, Don J. Selzer, Dimitrios Stefanidis, Raj Vuppalanchi |
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| Rok vydání: | 2020 |
| Předmět: |
Liver Cirrhosis
Male medicine.medical_specialty Cirrhosis Bariatric Surgery 03 medical and health sciences 0302 clinical medicine Weight loss Weight Loss medicine Humans In patient Liver decompensation Retrospective Studies Extreme obesity business.industry Background data Middle Aged medicine.disease Readmission rate Obesity Morbid Surgery Survival Rate Treatment Outcome Case-Control Studies 030220 oncology & carcinogenesis Female 030211 gastroenterology & hepatology medicine.symptom business Body mass index |
| Zdroj: | Annals of Surgery. 275:e174-e180 |
| ISSN: | 1528-1140 0003-4932 |
| DOI: | 10.1097/sla.0000000000003891 |
| Popis: | Objective To assess the safety and efficacy of bariatric surgery in patients with cirrhosis. Summary background data Bariatric surgery may be a viable option for patients with cirrhosis and extreme obesity. However, the risk of liver decompensation after surgery is not thoroughly investigated. Methods We conducted a case-controlled study with 106 obese patients with cirrhosis (cases) and 317 age, sex, body mass index-, and type of surgery-matched obese patients without cirrhosis (controls) who underwent bariatric surgery. Results Patients with cirrhosis were predominantly Child-Pugh class A (97%) with the diagnosis established prior to surgery in only 46%. In the cirrhosis group, there was no death in the first 30 days compared with 1 patient in the control group. At 90 days there was 1 death in the cirrhosis group but no additional deaths in the control group. In total, 12 months after the surgery, there were 3 deaths in the cirrhosis group and 1 in the control group (2.8% vs 0.6%, P = 0.056). The surgery-related length of stay was significantly longer in patients with cirrhosis (3.7 ± 4.0 vs 2.6 ± 2.4 d, P = 0.001), but the 30-day readmission rate was lower (7.5% vs 11.9%, P = 0.001). The percent of total weight loss at 30 and 90-days was not significantly different between the groups and remained that way even at 1 year (29.1 ± 10.9 vs 31.2 ± 9.4%, P = 0.096). Conclusions Bariatric surgery in obese cirrhotic patients is not associated with excessive mortality compared with noncirrhotic obese patients. |
| Databáze: | OpenAIRE |
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