Laparoscopic liver resection in obese patients

World J Surg. 2015 May;39(5):1210-5. doi: 10.1007/s00268-014-2927-y.

Abstract

Background: Obesity has been associated with worse postoperative outcomes than those for normal weight. Data on the short-term results of laparoscopic liver resection (LLR) in patients with obesity are scarce. Furthermore, the long-term outcomes of LLR versus open liver resection (OLR) have not been adequately assessed. The aims of this study were to analyze the outcomes of obese patients undergoing LLR and to compare these to the outcomes of obese patients undergoing OLR.

Methods: Data regarding the short-term results from 13 obese patients who underwent laparoscopic non-anatomical liver resection were retrospectively compared with the data from 69 obese patients who underwent open non-anatomical liver resection between 2002 and 2012. The long-term results of patients with hepatocellular carcinoma were also compared.

Results: A total of 82 patients who underwent non-anatomical liver resection in our institution were included. There were no differences between the two groups in terms of preoperative patient characteristics. The intraoperative blood loss in the laparoscopic group was significantly less than that in the open group. There were no significant differences in the postoperative complications or postoperative mortality. The postoperative hospital stay of the laparoscopic group was significantly shorter than that of the open group.

Conclusions: LLR in obese patients results in decreased intraoperative blood loss and shorter postoperative hospital stays compared with OLR. When performed in selected patients, LLR may be a safe and feasible option for obese patients.

Publication types

  • Comparative Study

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Blood Loss, Surgical
  • Carcinoma, Hepatocellular / pathology
  • Carcinoma, Hepatocellular / surgery*
  • Female
  • Hepatectomy / adverse effects
  • Hepatectomy / methods*
  • Humans
  • Laparoscopy* / adverse effects
  • Length of Stay
  • Liver Neoplasms / pathology
  • Liver Neoplasms / secondary
  • Liver Neoplasms / surgery*
  • Male
  • Middle Aged
  • Obesity / complications*
  • Operative Time
  • Retrospective Studies
  • Treatment Outcome
  • Tumor Burden