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Obesity Surgery
Published in: Obesity Surgery 1/2017

01-01-2017 | Original Contributions

Influence of Liver Disease on Perioperative Outcome After Bariatric Surgery in a Northern German Cohort

Authors: Stefan Wolter, Anna Duprée, Christina Coelius, Alexander El Gammal, Johannes Kluwe, Nina Sauer, Oliver Mann

Published in: Obesity Surgery | Issue 1/2017

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Abstract

Objectives

The aim of this study was to assess the prevalence of non-alcoholic fatty liver disease (NAFLD) in morbidly obese patients and evaluate the influence on perioperative complications.

Background

Patients undergoing bariatric surgery have a high incidence of non-alcoholic steatohepatitis (NASH). Upcoming data indicates that liver disease has a significant effect on perioperative complications. However, the influence of NAFLD/NASH on perioperative outcome in bariatric patients is still controversial.

Methods

We identified a total of 302 patients with concomitant liver biopsies, while performing either laparoscopic Roux-Y gastric bypass or sleeve gastrectomy. Liver biopsy was performed in case of abnormal liver appearance at time of bariatric surgery. Histological results were compared to perioperative complication rate.

Results

NAFLD is common in our patient cohort. Abnormal findings in liver histology were found in 82.3 % of our patients. Liver cirrhosis was newly diagnosed in 12 patients (4 %). There were no complications due to liver biopsy. The mortality rate was 0.3 %, leakage rate was 1 %, and postoperative bleeding occurred in 3.3 %. Pulmonary complications were observed in 1.7 % and cardiovascular complications in 1.3 %. One patient developed portal vein thrombosis and one patient acute pancreatitis; both were treated conservatively. No patient had postoperative liver failure. We found no association between histological findings and perioperative outcomes.

Conclusions

The prevalence of NAFLD among morbidly obese surgical patients was high, although this condition was not associated with increased risk for postoperative complications. Because of unexpected findings in intraoperative liver biopsies, the routine indication of liver biopsies in patients at high risk for liver disease should be discussed.
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Metadata
Title
Influence of Liver Disease on Perioperative Outcome After Bariatric Surgery in a Northern German Cohort
Authors
Stefan Wolter
Anna Duprée
Christina Coelius
Alexander El Gammal
Johannes Kluwe
Nina Sauer
Oliver Mann
Publication date
01-01-2017
Publisher
Springer US
Published in
Obesity Surgery / Issue 1/2017
Print ISSN: 0960-8923
Electronic ISSN: 1708-0428
DOI
https://doi.org/10.1007/s11695-016-2253-6

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