Effect of obesity on perioperative outcomes after laparoscopic hepatectomy

Lee, Seeyuen J.; Hauch, Adam; Kane, Erica D.; DuCoin, Christoper; Darden, Michael; Parker, Geoffrey E.; Kandil, Emad; Buell, Joseph F.

doi:10.20517/2394-5079.2016.34

Cited by 5 publications

(21 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…reported a significant increase in EBL between normal (177 mL) and overweight (234 mL) groups ( P < 0.05), but no difference between normal and obese (165 mL) or severely obese (254 mL) ( P = 0.95 and 0.22) 15 . None of the remaining studies demonstrated increased EBL in obese patients 15,16,18,20,21 . However, Uchida et al .…”

Section: Resultsmentioning

confidence: 92%

“…All studies reported mean or median post‐operative LOS. No difference in LOS was found between non‐obese and obese patients 15,16,19–21 . Yu et al .…”

Section: Resultsmentioning

confidence: 95%

“…Total patient numbers from all studies included were classified as 481 obese and 1180 non‐obese. Five of the seven studies recorded breakdown of pathology, with 42% of liver resections for malignant lesions and 58% benign pathology 15–19 . Of the four studies that reported the type of resection, 25% were major hepatectomies 15,16,19,20 …”

Section: Resultsmentioning

confidence: 99%

“…Two studies reported normal, overweight and obese subgroups undergoing LLR, 16,19 while Lee et al . also included severely obese patients 15 . Yu et al 21 .…”

Section: Resultsmentioning

confidence: 99%

“…The two studies performed in Western countries (France and the USA) classified obesity as a BMI of ≥30 kg/m 2 . Normal weight and overweight were considered BMI of <25 and 25–30, respectively 15,16 . The three studies from Japan 17,18,20 and one from China 21 defined obesity as a BMI of ≥25 kg/m 2 .…”

Section: Resultsmentioning

confidence: 99%

See 4 more Smart Citations

Body mass index and surgical outcomes in laparoscopic liver resections: a systematic review

Kwan

Waters

Keogh

et al. 2021

ANZ Journal of Surgery

View full text Add to dashboard Cite

Background Laparoscopic liver resection is gaining momentum; however, there is limited evidence on its efficacy and safety in obese patients. The aim of this study was to examine the relationship between BMI and outcomes after laparoscopic liver resection (LLR) using a systematic review of the existing literature. Methods A systematic search of Medline (Ovid 1946–present), PubMed (NCBI), Embase (Ovid 1966–present) and Cochrane Library was conducted using the Preferred Reporting Items for Systematic Reviews and Meta‐Analyses statement for parameters of LLR and BMI. Operative, post‐operative and oncological outcomes were recorded. Results Of 1460 abstracts, seven retrospective studies were analysed, published between 2015 and 2017 (study periods 1998–2017). Total patient cohort were classified as 481 obese and 1180 non‐obese with a median age range of 42.5–69.4 years. Variations existed in definitions of obesity (Asia BMI >25 kg/m2, Western BMI >30 kg/m2). Rates of conversion were examined in four studies (0–31%) with one reporting BMI >28 kg/m2 as an independent risk factor. Estimated blood loss and transfusion rates were similar. Operative time was increased in obese patients in one study (P = 0.02). Mortality rates ranged from 0% to 4.3% with no difference between BMI classes. No difference in major morbidity was demonstrated. Bile leak rates were increased in obese groups in one study (0–3.44%, P < 0.05). Wound infections were reported in five studies, with higher rates in obese patients (0–5.8% versus 0–1.9%). Tumour size was comparable in both groups. Completeness of resection was analysed in four studies with one study reporting increased R0 rates in obese patients (P = 0.012). Conclusion This systematic review highlights that current evidence shows LLR in obese patients is safe, however, further studies are required.

show abstract

Section: Resultsmentioning

confidence: 92%

“…All studies reported mean or median post‐operative LOS. No difference in LOS was found between non‐obese and obese patients 15,16,19–21 . Yu et al .…”

Section: Resultsmentioning

confidence: 95%

Section: Resultsmentioning

confidence: 99%

“…Two studies reported normal, overweight and obese subgroups undergoing LLR, 16,19 while Lee et al . also included severely obese patients 15 . Yu et al 21 .…”

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

See 3 more Smart Citations

Body mass index and surgical outcomes in laparoscopic liver resections: a systematic review

Kwan

Waters

Keogh

et al. 2021

ANZ Journal of Surgery

View full text Add to dashboard Cite

show abstract

Impact of body mass index on perioperative outcomes of laparoscopic major hepatectomies

Berardi

Kingham

Zhang

et al. 2023

Surgery

View full text Add to dashboard Cite

Assessment of Factors Associated with Morbidity and Textbook Outcomes of Laparoscopic Liver Resection in Obese Patients: A French Nationwide Study

Genser¹,

Lim²,

Barbier³

et al. 2022

Journal of the American College of Surgeons

View full text Add to dashboard Cite

BACKGROUND: Liver surgeons need to know the expected outcomes of laparoscopic liver resection (LLR) in obese patients. OBJECTIVE: The purpose of the present study is to assess morbidity, mortality and textbook outcomes (TO) after LLR in obese patients. METHODS: This is a French multicenter study of patients undergoing LLR between 1996 and 2018. Obesity was defined by a BMI at or above 30 kg/m2. Short-term outcomes and TO were compared between obese (ob) and nonobese (non-ob) patients. Factors associated with severe morbidity and TO were investigated. RESULTS: Of 3,154 patients included, 616 (19.5%) were obese. Ob-group patients had significantly higher American Society of Anesthesiologists (ASA) score and higher incidence of metabolic syndrome and chronic liver disease and were less likely to undergo major hepatectomy. Mortality rates were similar between ob and non-ob groups (0.8 vs 1.1%; p = 0.66). Overall morbidity and hospital stay were significantly increased in the ob group compared with the non-ob group (39.4 vs 34.7%, p = 0.03; and 9.5 vs 8.6 days, p = 0.02), whereas severe 90-day morbidity (at or above Clavien–Dindo grade III) was similar between groups (8% in both groups; p = 0.90). TO rate was significantly lower for the ob group than the non-ob group (58.3 vs 63.7%; p = 0.01). In multivariate analysis, obesity did not emerge as a risk factor for severe 90-day morbidity but was associated with a lower TO rate after LLR (odds ratio = 0.8, 95% CI 0.7–1.0; p = 0.03). CONCLUSIONS: LLR in obese patients is safe and effective with acceptable mortality and morbidity. Obesity had no impact on severe morbidity but was a factor for failing to achieve TO after LLR.

show abstract

Effect of obesity on perioperative outcomes after laparoscopic hepatectomy

Cited by 5 publications

References 0 publications

Body mass index and surgical outcomes in laparoscopic liver resections: a systematic review

Body mass index and surgical outcomes in laparoscopic liver resections: a systematic review

Impact of body mass index on perioperative outcomes of laparoscopic major hepatectomies

Assessment of Factors Associated with Morbidity and Textbook Outcomes of Laparoscopic Liver Resection in Obese Patients: A French Nationwide Study

Contact Info

Product

Resources

About