Benefit of laparoscopic liver resection in high body mass index patients

World J Gastroenterol. 2016 Mar 14;22(10):3015-22. doi: 10.3748/wjg.v22.i10.3015.

Abstract

Aim: To explore the impact of body mass index (BMI) on surgical outcomes in patients undergoing laparoscopic liver resection (LLR).

Methods: From January 2010 to February 2015, sixty-eight patients who underwent primary partial liver resection in our institute were retrospectively reviewed. Surgical outcomes of LLR were compared with those of open liver resection (OLR). In addition, we analyzed associations with BMI and surgical outcomes.

Results: Among 68 patients, thirty-nine patients underwent LLR and 29 were performed OLR. Significant difference in operation time, blood loss, and postoperative hospital stay was observed. There were no significant differences in mortality and morbidity in two groups. Twenty-two patients (32.4%) were classified as obese (BMI ≥ 25). A statistically significant correlation was observed between BMI and operation time, between BMI and blood loss in OLR, but not in LLR. The operation time and blood loss of OLR were significantly higher than that of LLR in obese patients. Open liver resection and BMI were independent predictors for prolonged operation time and increased blood loss in multivariate analysis.

Conclusion: The present study demonstrated that BMI had influenced to surgical outcomes of OLR. LLR was less influenced by BMI and had great benefit in obese patients.

Keywords: Body mass index; Increased blood loss; Laparoscopic liver resection; Obesity; Prolonged operation time.

MeSH terms

  • Aged
  • Blood Loss, Surgical / prevention & control
  • Body Mass Index*
  • Chi-Square Distribution
  • Female
  • Hepatectomy / adverse effects
  • Hepatectomy / methods*
  • Hepatectomy / mortality
  • Humans
  • Laparoscopy / adverse effects
  • Laparoscopy / mortality
  • Length of Stay
  • Liver Diseases / complications
  • Liver Diseases / diagnosis
  • Liver Diseases / mortality
  • Liver Diseases / surgery*
  • Logistic Models
  • Male
  • Middle Aged
  • Multivariate Analysis
  • Obesity / complications*
  • Obesity / diagnosis
  • Obesity / mortality
  • Odds Ratio
  • Operative Time
  • Patient Selection
  • Retrospective Studies
  • Risk Factors
  • Time Factors
  • Treatment Outcome