Outcome of bariatric surgery in patients with unexpected liver cirrhosis: A multicenter study from China

Q2 Medicine

Liver Research Pub Date : 2024-09-01 DOI:10.1016/j.livres.2024.08.001

Xia Sun , Libin Yao , Xing Kang , Weihua Yu , Fidele Kakule Kitaghenda , Mohammad Sajjad Ibn Rashid , Angeline Nogue Taguemkam , Jian Hong , Zhiyong Dong , Xitai Sun , Xiaocheng Zhu

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Abstract

Background and aims

Liver cirrhosis is a complex disease that may result in increased morbidity and mortality following bariatric surgery (BS). This study aimed to explore the outcome of BS in patients with unexpected cirrhosis, focusing on postoperative complications and the progression of liver disease.

Methods

A retrospective study of bariatric patients with cirrhosis from four centers in China between 2016 and 2023 was conducted, with follow-up for one year after BS. The primary outcome was the safety of BS in patients with unexpected cirrhosis, while the secondary outcome was the metabolic efficacy of BS in this group postoperatively.

Results

A total of 47 patients met the study criteria, including 46 cases of Child-Pugh class A cirrhosis and 1 case of Child-Pugh B. Pathological examination confirmed nodular cirrhosis in 21 patients (44.68%), pseudolobule formation in 1 patient (2.13%), lipedema degeneration with inflammatory cell infiltration in 3 patients (6.38%), and chronic hepatitis in 1 patient (2.13%). The average percentage of total weight loss was 29.73 ± 6.53% at one year postoperatively. During the 30-day postoperative period, the complication rate was 6.38%, which included portal vein thrombosis, gastrointestinal bleeding, and intra-abdominal infection. Moreover, no cases of liver decompensation or mortality were reported during the follow-up period. The remission rates of comorbidities among 41 patients one year after surgery were as follows: dyslipidemia 100%, type 2 diabetes 82.61%, hypertension 84.62%, and obstructive sleep apnea syndrome 85.71%.

Conclusions

BS can be safely performed in patients with unexpected cirrhosis in the compensated stage of liver disease, with low postoperative morbidity and no mortality observed during one-year follow-up.

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意外肝硬化患者的减肥手术效果：中国多中心研究

背景和目的肝硬化是一种复杂的疾病，可能导致减肥手术（BS）后发病率和死亡率增加。本研究旨在探讨意外肝硬化患者接受减重手术的结果，重点关注术后并发症和肝病进展。方法对中国四个中心在 2016 年至 2023 年期间接受减重手术的肝硬化患者进行回顾性研究，并在减重手术后随访一年。主要结果是意外肝硬化患者接受 BS 的安全性，次要结果是该组患者术后接受 BS 的代谢疗效。结果共有 47 例患者符合研究标准，包括 46 例 Child-Pugh A 级肝硬化和 1 例 Child-Pugh B 级肝硬化。病理检查证实结节性肝硬化 21 例（44.68%），假小叶形成 1 例（2.13%），脂肪水肿变性伴炎症细胞浸润 3 例（6.38%），慢性肝炎 1 例（2.13%）。术后一年，总重量的平均百分比为（29.73 ± 6.53）%。术后 30 天内，并发症发生率为 6.38%，包括门静脉血栓、消化道出血和腹腔内感染。此外，随访期间没有出现肝功能失代偿或死亡病例。41例患者术后一年的合并症缓解率如下：血脂异常100%、2型糖尿病82.61%、高血压84.62%、阻塞性睡眠呼吸暂停综合征85.71%。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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