Considerations for bariatric surgery in patients with cirrhosis

Table 1 Study characteristics of bariatric surgery in patients with cirrhosis

Author, year	Number. cirrhotics	Childs status	Procedure	Average op time	Averageblood loss	LOS	Complication	Mortality	Comments
Brolin 1998	8	NR	7 RYGB, 1 JIB reversal	NR	543 mL	NR	Ascitic fluid leak, marginal ulcer, amputation	1 periop death, 2 late deaths
Dallal 2004	30	A	27 lap RYGB, 3 lap SG	4 h	290 mL	4	ATN, anastomotic leak, blood transfusion, prolonged ileus, prolonged intubation	1 late unrelated death	%EWL at 12 mo 63%
Takata 2008	6	4 A, 2B	6 Lap SG	141 min	58 mL	4.2	2 pts, development of ascites, HE post UTI	Nil	%EWL at 9 mo 33%
Shimizu 2013	23	22 A, 1B	14 lap RYGB, 8 lap SG, 1 LAGB	NR	NR	4.3	8 pts, anastomotic leak, stricture, infected hematoma, pneumonia	1 death 9 months postop of unknown cause
Lin 2013	20	NR	Lap SG	151 min	NR	4.2	2 wound infections, 1 transient HE, 1 transient renal insufficiency, 1 bleeding, 1 staple line leak	1 death 4 years postop, 2 deaths on liver tx waiting list
Rebibo 2014	13	13 A	13 lap SG	75 min	NR	3	1 postop intra-abdo hematoma	Nil	%EWL at 6 mo 61.9%
Hughes 2014	1	A	Lap SG	NR	NR	NR	Portal vein thrombosis with mesenteric ischaemia	Nil
Woodford 2015	14	NR	14 LAGB	NR	NR	NR	1 postop surgical site infection, 1 revision of malpositioned band	1 unrelated death 11 yr post surg	%EWL at 12 mo 61.3%
Pestana 2015	14	A	11 SG, 3 RYGB	NR	NR	NR	1 unrelated HE 2 yr post-surgery	Nil	%Total weight loss at 24 mo 25.6%
Wolter 2016	12	NR	12 lap procedures	NR	NR	NR	1 staple line leak, 1 intra-abdominal abscess, 1 intraluminal bleed, 1 dysrhythmia	Nil	No significant association betw cirrhosis and periop events

NR: Not recorded; JIB: Jejunoileal bypass; SG: Sleeve gastrectomy; RYGB: Roux-en-Y gastric bypass; LAGB: Laparoscopic adjustable gastric banding; BPD: Biliopancreatic diversion; lap: Laparoscopic; %EWL: Percentage excess weight loss.