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Obesity Surgery
Published in: Obesity Surgery 11/2018

01-11-2018 | Original Contributions

Bariatric Surgery in Patients with Cirrhosis and Portal Hypertension

Authors: Zubaidah Nor Hanipah, Suriya Punchai, Arthur McCullough, Srinivasan Dasarathy, Stacy A. Brethauer, Ali Aminian, Philip R. Schauer

Published in: Obesity Surgery | Issue 11/2018

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Abstract

Introduction

Studies on bariatric patients with cirrhosis and portal hypertension are limited. The aim of this study was to review our experience in cirrhotic patients with portal hypertension who had bariatric surgery.

Method

All cirrhotic patients with portal hypertension who underwent laparoscopic bariatric surgery, from 2007 to 2017, were retrospectively reviewed.

Results

Thirteen patients were included; eight (62%) were female. The median age was 54 years (interquartile range, IQR 49–60) and median BMI was 48 kg/m2 (IQR 43–55). Portal hypertension was diagnosed based on endoscopy (n = 5), imaging studies (n = 3), intraoperative increased collateral circulation (n = 2), and endoscopy and imaging studies (n = 3). The bariatric procedures included sleeve gastrectomy (n = 10, 77%) and Roux-en-Y gastric bypass (n = 3, 23%). The median length of hospital stay was 3 days (IQR 2–4). Three 30-day complications occurred including wound infection (n = 1), intra-abdominal hematoma (n = 1), and subcutaneous hematoma (n = 1). No intraoperative or 30-day mortalities. There were 11 patients (85%) at 1-year follow-up and 9 patients (69%) at 2-year follow-up. At 2 years, the median percentage of excess weight loss (EWL) and total weight loss (TWL) were 49 and 25%, respectively. There was significant improvement in diabetes (100%), dyslipidemia (100%), and hypertension (50%) at 2 years after surgery.

Conclusion

Bariatric surgery in selected cirrhotic patients with portal hypertension is relatively safe and effective.
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Metadata
Title
Bariatric Surgery in Patients with Cirrhosis and Portal Hypertension
Authors
Zubaidah Nor Hanipah
Suriya Punchai
Arthur McCullough
Srinivasan Dasarathy
Stacy A. Brethauer
Ali Aminian
Philip R. Schauer
Publication date
01-11-2018
Publisher
Springer US
Published in
Obesity Surgery / Issue 11/2018
Print ISSN: 0960-8923
Electronic ISSN: 1708-0428
DOI
https://doi.org/10.1007/s11695-018-3372-z

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