Abstract
Background
Laparoscopic sleeve gastrectomy (SG) is a validated procedure for the surgical treatment
of morbid obesity. Cirrhosis is often considered a relative contraindication to elective
extrahepatic surgery. The objective of this study was to evaluate the morbidity related
to SG performed in cirrhotic patients compared with noncirrhotic patients.
Methods
Between March 2004 and January 2013, we included all patients with cirrhosis undergoing
SG (13 patients). These patients (SG-cirrhosis group) were matched in terms of preoperative
data (age, gender, body mass index, and co-morbidities) on a 1:2 basis, with 26 noncirrhotic
patients (SG group) selected from a population of 750 patients. Cirrhosis was diagnosed
postoperatively on histologic exam. The primary endpoint was the overall postoperative
complication rate. Secondary endpoints were operating time, revisional surgery rate,
gastric fistula and bleeding rates, postoperative mortality, and weight loss over
a 24-month period.
Results
The SG-cirrhosis group consisted of 13 patients with a median age of 52 years. All
patients in the SG-cirrhosis group were Child A. Etiology of cirrhosis was related
to NASH in 93.3%. Median operating time in the SG-cirrhosis group and SG group was
75 minutes versus 80 minutes (P = .59). No postoperative mortality was observed in either group. The overall postoperative
complication rate was 7.7% versus 7.7% (P = 1). The major complication rate was 0% versus 7.7% (P = .22), and the postoperative gastric fistula rate was 0% versus 3.8% (P = .47). No complications related to cirrhosis were reported.
Conclusion
SG can be performed in Child A cirrhosis with no increased risk of postoperative complications
and no specific complications related to cirrhosis. Weight loss for patients with
cirrhosis undergoing SG is similar to that observed in noncirrhotic patients.
Keywords
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Article info
Publication history
Published online: October 03, 2013
Accepted:
September 27,
2013
Received:
August 8,
2013
Identification
Copyright
© 2014 American Society for Bariatric Surgery. Published by Elsevier Inc. All rights reserved.
