A Systematic Review of Bariatric Surgery in Patients with Liver Cirrhosis

Overview

Journal Obes Surg

Date 2015 May 19

PMID 25982807

Citations 44

Authors

Ahmad Jan

Mahendra Narwaria

Kamal K Mahawar

Affiliations

Soon will be listed here.

Abstract

Nonalcoholic steatohepatitis is becoming a common cause of liver cirrhosis and a significant number of patients undergoing bariatric surgery suffer with it. There is currently lack of consensus among surgeons regarding safety of bariatric surgery in patients with liver cirrhosis and the best bariatric procedure in these patients. This review investigates published English language scientific literature systematically in an attempt to answer these questions. Eleven studies that reported experience of bariatric surgery in cirrhotic obese patients were included in this review. This review shows an acceptably higher overall risk of complications and perioperative mortality with bariatric surgery in cirrhotic patients. Surgeons must discuss the possibility of an unexpected intraoperative diagnosis of cirrhosis preoperatively with all bariatric surgery patients and agree on a course of action.

Citing Articles

Bariatric surgery reduces long-term mortality in patients with metabolic dysfunction-associated steatotic liver disease and cirrhosis.

Rouillard N, Barnett S, Zhang X, Kam L, Manikat R, Cheung R Clin Mol Hepatol. 2024; 31(1):227-239.

PMID: 39541951 PMC: 11791598. DOI: 10.3350/cmh.2024.0564.

A roadmap for clinical trials in MASH-related compensated cirrhosis.

Pericas J, Anstee Q, Augustin S, Bataller R, Berzigotti A, Ciudin A Nat Rev Gastroenterol Hepatol. 2024; 21(11):809-823.

PMID: 39020089 DOI: 10.1038/s41575-024-00955-8.

TASL Practice Guidance on the Clinical Assessment and Management of Patients with Nonalcoholic Fatty Liver Disease.

Yilmaz Y, Zeybel M, Adali G, Cosar A, Sertesen E, Gokcan H Hepatol Forum. 2023; 4(Suppl 1):1-32.

PMID: 37920782 PMC: 10588738. DOI: 10.14744/hf.2023.2023.0011.

Newly diagnosed Crohn's disease, and hepatocellular and renal cell carcinoma in a bariatric surgery patient-dealing with the complexity of obesity-associated diseases: a case report and review of the literature.

Seidemann L, Dietrich A J Med Case Rep. 2023; 17(1):379.

PMID: 37667406 PMC: 10478449. DOI: 10.1186/s13256-023-04111-9.

From Listing to Recovery: A Review of Nutritional Status Assessment and Management in Liver Transplant Patients.

Ravaioli F, De Maria N, Di Marco L, Pivetti A, Casciola R, Ceraso C Nutrients. 2023; 15(12).

PMID: 37375682 PMC: 10301963. DOI: 10.3390/nu15122778.

References

Millwala F, Nguyen G, Thuluvath P . Outcomes of patients with cirrhosis undergoing non-hepatic surgery: risk assessment and management. World J Gastroenterol. 2007; 13(30):4056-63. PMC: 4205305. DOI: 10.3748/wjg.v13.i30.4056. View

Brolin R, Bradley L, Taliwal R . Unsuspected cirrhosis discovered during elective obesity operations. Arch Surg. 1998; 133(1):84-8. DOI: 10.1001/archsurg.133.1.84. View

Kral J, Thung S, Biron S, Hould F, Lebel S, Marceau S . Effects of surgical treatment of the metabolic syndrome on liver fibrosis and cirrhosis. Surgery. 2003; 135(1):48-58. DOI: 10.1016/j.surg.2003.10.003. View

Weingarten T, Swain J, Kendrick M, Charlton M, Schroeder B, Lee R . Nonalcoholic steatohepatitis (NASH) does not increase complications after laparoscopic bariatric surgery. Obes Surg. 2011; 21(11):1714-20. DOI: 10.1007/s11695-011-0521-z. View

Dallal R, Mattar S, Lord J, Watson A, Cottam D, Eid G . Results of laparoscopic gastric bypass in patients with cirrhosis. Obes Surg. 2004; 14(1):47-53. DOI: 10.1381/096089204772787284. View

Angulo P . NAFLD, obesity, and bariatric surgery. Gastroenterology. 2006; 130(6):1848-52. DOI: 10.1053/j.gastro.2006.03.041. View

Baltasar A . Liver cirrhosis and bariatric operations. Surg Obes Relat Dis. 2006; 2(5):580. DOI: 10.1016/j.soard.2006.07.003. View

Berzigotti A, Garcia-Tsao G, Bosch J, Grace N, Burroughs A, Morillas R . Obesity is an independent risk factor for clinical decompensation in patients with cirrhosis. Hepatology. 2011; 54(2):555-61. PMC: 3144991. DOI: 10.1002/hep.24418. View

Silverman J, OBrien K, Long S, Leggett N, Khazanie P, Pories W . Liver pathology in morbidly obese patients with and without diabetes. Am J Gastroenterol. 1990; 85(10):1349-55. View

10.

Csikesz N, Nguyen L, Tseng J, Shah S . Nationwide volume and mortality after elective surgery in cirrhotic patients. J Am Coll Surg. 2009; 208(1):96-103. DOI: 10.1016/j.jamcollsurg.2008.09.006. View

11.

Pestana L, Swain J, Dierkhising R, Kendrick M, Kamath P, Watt K . Bariatric surgery in patients with cirrhosis with and without portal hypertension: a single-center experience. Mayo Clin Proc. 2015; 90(2):209-15. DOI: 10.1016/j.mayocp.2014.11.012. View

12.

Sarr M . Is a bariatric procedure appropriate in patients with portal hypertension secondary to cirrhosis?. Surg Obes Relat Dis. 2006; 2(3):405-6, discussion 406-7. DOI: 10.1016/j.soard.2006.01.012. View

13.

Mosko J, Nguyen G . Increased perioperative mortality following bariatric surgery among patients with cirrhosis. Clin Gastroenterol Hepatol. 2011; 9(10):897-901. DOI: 10.1016/j.cgh.2011.07.007. View

14.

Woodford R, Burton P, OBrien P, Laurie C, Brown W . Laparoscopic Adjustable Gastric Banding In Patients with Unexpected Cirrhosis: Safety and Outcomes. Obes Surg. 2015; 25(10):1858-62. DOI: 10.1007/s11695-015-1623-9. View

15.

Shimizu H, Phuong V, Maia M, Kroh M, Chand B, Schauer P . Bariatric surgery in patients with liver cirrhosis. Surg Obes Relat Dis. 2012; 9(1):1-6. DOI: 10.1016/j.soard.2012.07.021. View

16.

Diniz M, Moura L, Kelles S, Diniz M . Long-term mortality of patients submitted to Roux-en-Y gastric bypass in Public Health System: high prevalence of alcoholic cirrhosis and suicides. Arq Bras Cir Dig. 2014; 26 Suppl 1:53-6. DOI: 10.1590/s0102-67202013000600012. View

17.

Takata M, Campos G, Ciovica R, Rabl C, Rogers S, Cello J . Laparoscopic bariatric surgery improves candidacy in morbidly obese patients awaiting transplantation. Surg Obes Relat Dis. 2008; 4(2):159-64. DOI: 10.1016/j.soard.2007.12.009. View

18.

Rebibo L, Gerin O, Verhaeghe P, Dhahri A, Cosse C, Regimbeau J . Laparoscopic sleeve gastrectomy in patients with NASH-related cirrhosis: a case-matched study. Surg Obes Relat Dis. 2013; 10(3):405-10. DOI: 10.1016/j.soard.2013.09.015. View

19.

Bromberger B, Porrett P, Choudhury R, Dumon K, Murayama K . Weight loss interventions for morbidly obese patients with compensated cirrhosis: a Markov decision analysis model. J Gastrointest Surg. 2013; 18(2):321-7. DOI: 10.1007/s11605-013-2298-y. View