We found a match
Your institution may have access to this item. Find your institution then sign in to continue.
- Title
Bariatric Surgery in Cirrhotic Patients: a Matched Case-Control Study.
- Authors
Quezada, Nicolás; Maturana, Gregorio; Irarrázaval, María Jesús; Muñoz, Rodrigo; Morales, Sebastián; Achurra, Pablo; Azócar, Cristóbal; Crovari, Fernando
- Abstract
Introduction: Laparoscopic bariatric surgery (LBS) in liver end-stage organ disease has been proven to improve organ function and patients' symptoms. A series of LBS in patients with cirrhosis have shown good results in weight loss, but increased risk of complications. Current literature is based on clinical series. This paper aims to compare LBS (69% gastric bypass) between patients with cirrhosis and without cirrhosis. Methods: We conducted a retrospective 1:3 matched case-control study including bariatric patients with cirrhosis and without cirrhosis. Demographics, operative variables, postoperative complications, long-term weight loss, and comorbidity resolution were compared between groups. Results: Sixteen Child A patients were included in the patients with cirrhosis (PC) group and 48 in patients without cirrhosis (control) group. Mean age was 50 years; preoperative BMI was 39 ± 6.8 kg/m2. Laparoscopic gastric bypass and laparoscopic sleeve gastrectomy were performed in 69% and 31%, respectively. Follow-up was 81% at 2 years for both groups. PC group had a higher rate of overall (31% vs. 6%; p < 0.05) and severe (Clavien-Dindo ≥ III; 13% vs. 0%; p = 0.013) complications than that of the control group. Mean %EWL of PC at 2 years of follow-up was 84.9%, without differences compared with that of the control group (83.1%). Comorbidity remission in PC was 14%, 50%, and 85% for hypertension, type 2 diabetes, and dyslipidemia, respectively. Patients without cirrhosis had a higher resolution rate of hypertension (65% vs. 14%, p = 0.03). Conclusion: LBS is effective for weight loss and comorbidity resolution in patients with obesity and Child A liver cirrhosis. However, these results are accompanied by significantly increased risk of complications.
- Subjects
CASE-control method; GASTRIC bypass; BARIATRIC surgery; GASTRIC banding; TYPE 2 diabetes; CHILD patients; MORBID obesity; OVERWEIGHT children
- Publication
Obesity Surgery, 2020, Vol 30, Issue 12, p4724
- ISSN
0960-8923
- Publication type
Article
- DOI
10.1007/s11695-020-04929-y