Outcomes of Bariatric Surgery in Patients with Cirrhosis

Inka Miñambres, Miguel Angel Rubio, Ana de Hollanda, Irene Breton, Nuria Vilarrasa, Silvia Pellitero, Marta Bueno, Albert Lecube, Clara Marcuello, Albert Goday, Maria D. Ballesteros, German Soriano, Assumpta Caixàs

Research output: Contribution to journalArticleResearch

9 Citations (Scopus)

Abstract

© 2018, Springer Science+Business Media, LLC, part of Springer Nature. Context: Information concerning the risk–benefit profile of bariatric surgery in subjects with liver cirrhosis is scarce. Our aim was to describe the long-term outcomes of bariatric surgery in a cohort of patients with liver cirrhosis submitted to bariatric surgery. Methods: This was a multicenter, retrospective observational study performed by the Obesity Group of the Spanish Society of Endocrinology and Nutrition (GOSEEN), with a review of patients with cirrhosis who had undergone bariatric surgery during the period from April 2004 to March 2017 in ten public reference hospitals in Spain. Results: Data on 41 patients with cirrhosis submitted to obesity surgery were collected (mean age 53.8 ± 7.9 years, 46.3% women, presurgical BMI 45 ± 8.3 kg/m 2 ). All but one patient belonged to Child–Pugh class A, and sleeve gastrectomy was conducted in 68.3% of cases. Percentage of total weight loss (%TWL) was 26.33 ± 8.3% and 21.16 ± 15.32% at 1 and 5 years after surgery, respectively. This was accompanied by a significant reduction of type 2 diabetes, high blood pressure, and dyslipidemia and by an improvement of liver enzymes over time. Model for End-Stage Liver Disease (MELD) index increased from 7.2 ± 1.9 to 9.8 ± 4.6 after 5 years. Seven patients (17%) developed early postsurgical complications. No postsurgical mortality was observed. During follow-up, only five patients developed liver decompensation. Conclusions: Bariatric surgery in selected patients with liver cirrhosis has metabolic benefits that could have a positive impact on liver prognosis. Trial Registration: Controlledtrials.com Identifier: 10.1186/ISRCTN15009106.
Original languageEnglish
Pages (from-to)585-592
JournalObesity Surgery
Volume29
DOIs
Publication statusPublished - 15 Feb 2019

Keywords

  • Cirrhosis
  • Liver
  • Obesity surgery

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