Bariatric surgery in patients with liver cirrhosis Journal Article

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Authors: Shimizu, H.; Phuong, V.; Maia, M.; Kroh, M; Chand, B; Schauer, P. R.; Brethauer, S. A.
Article Title: Bariatric surgery in patients with liver cirrhosis
Abstract: BACKGROUND: Data regarding the management of bariatric patients with cirrhosis are scarce, and there is no strong evidence that supports a specific approach for this group of patients. The aim of this study was to review our experience with cirrhotic patients undergoing bariatric surgery. METHODS: A prospectively maintained database was reviewed to assess the outcomes of bariatric surgery for patients with known cirrhosis and for patients with cirrhosis discovered at surgery (unknown cirrhosis). RESULTS: From April 2004 to September 2011, 23 patients (12 with known cirrhosis and 11 with unknown cirrhosis) met inclusion criteria. There were 14 females and 9 males with a mean age of 51.5 +/- 8.3 and a mean body mass index of 48.2 +/- 8.6 kg/m2. Child-Pugh classes were A (n = 22) and B (n = 1). Patients had a high frequency of diabetes (83%), dyslipidemia (61%), and hypertension (83%). Procedures performed were laparoscopic Roux-en-Y gastric bypass (LRYGB) (n = 14), laparoscopic sleeve gastrectomy (LSG) (n = 8), and laparoscopic adjustable gastric banding (n = 1). Two patients underwent LSG successfully after transjugular intrahepatic portosystemic shunt. Mean length of hospital stay was 4.3 +/- 2.7 days. Complications developed in 8 patients. One patient died of unknown cause 9 months after surgery. No patients had liver decompensation after surgery. The patients lost 67.4% +/- 30.9% of their excess weight at 12 months follow-up and 67.7% +/- 24.8% at 37 months follow-up. CONCLUSION: LRYGB and LSG can be performed without prohibitive complication rates in carefully selected patients with cirrhosis. In our experience, bariatric patients with cirrhosis achieved excellent weight loss and improvement in obesity-related co-morbidities.
Journal Title: Surgery for obesity and related diseases : official journal of the American Society for Bariatric Surgery
Volume: 9
Issue: 1
ISSN: 1878-7533; 1550-7289
Publisher: Elsevier Inc  
Journal Place: United States
Date Published: 2013
Start Page: 1
End Page: 6
Language: eng
DOI/URL:

10.1016/j.soard.2012.07.021

10.1016/j.soard.2012.07.021
Notes: CI: Copyright (c) 2013; JID: 101233161; 2012/04/04 [received]; 2012/07/23 [revised]; 2012/07/24 [accepted]; 2012/09/11 [aheadofprint]; ppublish
LUC Authors
  1. Bipan Chand
    48 Chand
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