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Lee et al. Hepatoma Res 2016;2:323-7 Hepatoma Research
DOI: 10.20517/2394-5079.2016.34
www.hrjournal.net
Original Article Open Access

Effect of obesity on perioperative

outcomes after laparoscopic hepatectomy

Seeyuen J. Lee , Adam Hauch , Erica Kane , Christoper DuCoin , Michael Darden , Geoffrey Parker , Emad Kandil ,
3
4
2
2
1
2
2
Joseph F. Buell 1,2
1 Departments of Surgery, Louisiana State University School of Medicine, New Orleans, LA 70112, USA
2 Departments of Surgery, Tulane University School of Medicine, New Orleans, LA 70112, USA
3 Department of Economics, Tulane University, New Orleans, LA 70112, USA
4 Tuck School of Business Administration, Dartmouth College, Hanover, NH 03755, USA
Correspondence to: Prof. Joseph F. Buell, Tulane Transplant Institute, Department of Surgery, Tulane University School of Medicine, 1415 Tulane Ave,
New Orleans, LA 70112, USA. E-mail: jbuell1@tulane.edu
How to cite this article: Lee SJ, Hauch A, Kane E, DuCoin C, Darden M, Parker G, Kandil E, Buell JF. Effect of obesity on perioperative outcomes
after laparoscopic hepatectomy. Hepatoma Res 2016;2:323-7.
ABSTRACT

Article history: Aim: Laparoscopic hepatectomy is increasing in utilization, however the procedure has not
Received: 26-08-2016 been adequately examined in the obese patient. This study aims to analyze the effect of obesity
Accepted: 17-10-2016 on perioperative outcomes after laparoscopic hepatectomy. Methods: Retrospective analysis
Published: 13-12-2016 of 396 laparoscopic hepatectomies in normal [body mass index (BMI) < 25], overweight (BMI
≥ 25), obese (BMI ≥ 30), and severely obese (BMI ≥ 35) patients using multivariate regression
Key words: models to determine the risk factors for post-operative complications. Results: Normal BMI
Liver resection, (n = 78; 20%), overweight (n = 209; 52%), obese (n = 86; 22%), and severely obese (n = 23;
laparoscopy, 6%). Demographics were similar except for a higher American Society of Anesthesiologists
obesity (ASA) score in the obese group. Estimated blood loss and operating time were greatest in the
overweight group, while length of stay and complications were statistically similar between
groups. Univariate analysis identified that complications were associated with weight class,
ASA score, blood loss, and resection; multivariate analysis revealed ASA and transfusion were
best correlated with complications. Conclusion: Obese and overweight patients have similar
complication profiles to normal BMI patients while severely obese patients have a higher
incidence of complications that are primarily limited to Clavien-Dindo class I and II.

INTRODUCTION now obese, and with the introduction of the Western
diet these figures are climbing in both Europe and
Obese patients have frequently been perceived as Asia. [1,2] Worldwide, the prevalence of obesity has
[3]
challenging operative candidates often believed nearly doubled between 1980 and 2008. Despite
to incur increases in complications. Obesity is not the dramatic rise in obesity, few studies have carefully
only an increasing problem in the United States, but examined the impact of a laparoscopic approach on the
worldwide. Over 35% of the American population is surgical outcomes of liver resection in these patients.

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