Results of laparoscopic gastric bypass in patients with cirrhosis

• Published in: Obesity surgery 2004-01, Vol.14 (1), p.47-53
• Main Authors: Dallal, Ramsey M, Mattar, Samer G, Lord, Jeffrey L, Watson, Andrew R, Cottam, Daniel R, Eid, George M, Hamad, Giselle, Rabinovitz, Mordecai, Schauer, Philip R
• Format: Article
• Language: English
• Subjects: Adult; Body Mass Index; Fatty Liver - complications; Female; Gastric Bypass - methods; Gastrointestinal surgery; Humans; Laparoscopy; Liver cirrhosis; Liver Cirrhosis - etiology; Liver Cirrhosis - pathology; Male; Middle Aged; Obesity, Morbid - complications; Obesity, Morbid - surgery; Postoperative Complications; Retrospective Studies; Surgical outcomes; Treatment Outcome; Weight control
• ISSN: 0960-8923; 1708-0428
• DOI: 10.1381/096089204772787284

The safety and efficacy of bariatric surgery in patients with cirrhosis has not been well studied. A retrospective review was conducted of patients with cirrhosis who underwent weight-loss surgery at a single institution. Out of a total of 2119 patients who underwent laparoscopic Roux-en-Y gastric bypass (RYGBP), 30 patients (1.4%) with cirrhosis were identified. When compared with the entire cohort, patients with cirrhosis were significantly more prone to be heavier (BMI 53 vs 48), older in years (age 50 vs 45), more likely to be male (RR=1.3), and have a higher incidence of diabetes (70% vs 21%) and hypertension (67% vs 21%), P12 months postoperatively (n=15), the average percent excess weight loss was 63+/-15%. Laparoscopic RYGBP in the cirrhotic patient has an acceptable complication rate and achieves satisfactory early weight loss. Patients tend to be heavier, older, male and more likely to have diabetes and hypertension. Long-term studies are necessary to examine how weight loss impacts established cirrhosis.