Outcome of bariatric surgery in patients with unexpected liver cirrhosis: A multicenter study from China

Abstract

Background and aims: Liver cirrhosis is a complex disease that may result in increased morbidity and mortality following bariatric surgery (BS). This study aimed to explore the outcome of BS in patients with unexpected cirrhosis, focusing on postoperative complications and the progression of liver disease.

Methods: A retrospective study of bariatric patients with cirrhosis from four centers in China between 2016 and 2023 was conducted, with follow-up for one year after BS. The primary outcome was the safety of BS in patients with unexpected cirrhosis, while the secondary outcome was the metabolic efficacy of BS in this group postoperatively.

Results: A total of 47 patients met the study criteria, including 46 cases of Child-Pugh class A cirrhosis and 1 case of Child-Pugh B. Pathological examination confirmed nodular cirrhosis in 21 patients (44.68%), pseudolobule formation in 1 patient (2.13%), lipedema degeneration with inflammatory cell infiltration in 3 patients (6.38%), and chronic hepatitis in 1 patient (2.13%). The average percentage of total weight loss was 29.73±6.53% at one year postoperatively. During the 30-day postoperative period, the complication rate was 6.38%, which included portal vein thrombosis, gastrointestinal bleeding, and intra-abdominal infection. Moreover, no cases of liver decompensation or mortality were reported during the follow-up period. The remission rates of comorbidities among 41 patients one year after surgery were as follows: dyslipidemia 100%, type 2 diabetes 82.61%, hypertension 84.62%, and obstructive sleep apnea syndrome 85.71%.

Conclusions: BS can be safely performed in patients with unexpected cirrhosis in the compensated stage of liver disease, with low postoperative morbidity and no mortality observed during one-year follow-up.

Keywords

Bariatric surgery(BS) / Metabolic surgery / Liver cirrhosis / Obesity / Type 2 diabetes mellitus (T2M)

Data availability statement

The datasets evaluated in the current study are available from the corresponding author upon request.

Authors’ contributions

Xia Sun, Libin Yao, and Xing Kang contributed equally to this work and should be considered co-first authors. Xia Sun: Writing e original draft. Libin Yao: Conceptualization. Xing Kang: Concep-tualization. Weihua Yu: Writing e review & editing. Fidele Kakule Kitaghenda: Formal analysis. Mohammad Sajjad Ibn Rashid: Formal analysis. Angeline Nogue Taguemkam: Data curation. Jian Hong: Data curation. Zhiyong Dong: Writing e review & editing, Supervision. Xitai Sun: Writing e review & editing, Supervision. Xiaocheng Zhu: Writing e review & editing, Supervision.

Declaration of competing interest

The authors declare that they have no conflict of interest.

Acknowledgements

This study was supported by the Science and Technology Pro-gram of Xuzhou (No. KC22231) of China.

Appendix A. Supplementary data

Supplementary data to this article can be found online at https://doi.org/10.1016/j.livres.2024.08.001.

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