Retrospective Study
Copyright ©The Author(s) 2016. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Mar 14, 2016; 22(10): 3015-3022
Published online Mar 14, 2016. doi: 10.3748/wjg.v22.i10.3015
Benefit of laparoscopic liver resection in high body mass index patients
Hiroki Uchida, Yukio Iwashita, Kunihiro Saga, Hiroomi Takayama, Kiminori Watanabe, Yuichi Endo, Kazuhiro Yada, Masayuki Ohta, Masafumi Inomata
Hiroki Uchida, Yukio Iwashita, Kunihiro Saga, Hiroomi Takayama, Kiminori Watanabe, Yuichi Endo, Kazuhiro Yada, Masayuki Ohta, Masafumi Inomata, Department of Gastroenterological and Pediatric Surgery, Oita University Faculty of Medicine, Oita 879-5593, Japan
Author contributions: Uchida H, Iwashita Y, Saga K, Takayama H, Watanabe K, Endo Y, Yada K, Ohta M and Inomata M contributed equally to this work; and Uchida H designed the study and wrote the manuscript.
Institutional review board statement: The study was reviewed and approved by the Oita University Institutional Review Board.
Informed consent statement: All study participants provided informed written consent prior to study enrollment.
Conflict-of-interest statement: The authors have no conflict of interest.
Data sharing statement: Technical appendix, statistical code, and dataset available from the corresponding author at ucchy@oita-u.ac.jp. Participants gave informed consent was not obtained but the presented data are anonymized and risk of identification is low.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Hiroki Uchida, MD, PhD, Department of Gastroenterological and Pediatric Surgery, Oita University Faculty of Medicine, 1-1 Hasama-machi, Yufu, Oita 879-5593, Japan. ucchy@oita-u.ac.jp
Telephone: +81-97-5865843 Fax: +81-97-5496039
Received: October 10, 2015
Peer-review started: October 14, 2015
First decision: November 13, 2015
Revised: November 17, 2015
Accepted: December 8, 2015
Article in press: December 8, 2015
Published online: March 14, 2016
Processing time: 143 Days and 7.4 Hours
Abstract

AIM: To explore the impact of body mass index (BMI) on surgical outcomes in patients undergoing laparoscopic liver resection (LLR).

METHODS: From January 2010 to February 2015, sixty-eight patients who underwent primary partial liver resection in our institute were retrospectively reviewed. Surgical outcomes of LLR were compared with those of open liver resection (OLR). In addition, we analyzed associations with BMI and surgical outcomes.

RESULTS: Among 68 patients, thirty-nine patients underwent LLR and 29 were performed OLR. Significant difference in operation time, blood loss, and postoperative hospital stay was observed. There were no significant differences in mortality and morbidity in two groups. Twenty-two patients (32.4%) were classified as obese (BMI ≥ 25). A statistically significant correlation was observed between BMI and operation time, between BMI and blood loss in OLR, but not in LLR. The operation time and blood loss of OLR were significantly higher than that of LLR in obese patients. Open liver resection and BMI were independent predictors for prolonged operation time and increased blood loss in multivariate analysis.

CONCLUSION: The present study demonstrated that BMI had influenced to surgical outcomes of OLR. LLR was less influenced by BMI and had great benefit in obese patients.

Keywords: Laparoscopic liver resection; Obesity; Body mass index; Prolonged operation time; Increased blood loss

Core tip: This study presented the correlation between body mass index (BMI) and surgical outcomes of 68 cases performed laparoscopic liver resection (LLR) and open liver resection (OLR). A statistically significant correlation was observed between BMI and operation time, between BMI and blood loss in OLR, but not in LLR. Open liver resection and BMI were independent predictors for prolonged operation time and increased blood loss in multivariate analysis. LLR in obese patients was safe and had great benefit without prolonged operation time and increased blood loss.