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©The Author(s) 2021.
World J Gastrointest Surg. Jan 27, 2021; 13(1): 19-29
Published online Jan 27, 2021. doi: 10.4240/wjgs.v13.i1.19
Published online Jan 27, 2021. doi: 10.4240/wjgs.v13.i1.19
Table 1 Patients’ characteristics in the overweight and obese group (body mass index 25 kg/m²)
| LH vs OH | |||
| LH cohort (n = 68) | OH cohort (n = 68) | P value | |
| Demographics | |||
| Sex, n (%) | 0.116 | ||
| Male | 36 (52.9) | 45 (66.2) | |
| Female | 32 (47.1) | 23 (33.8) | |
| Age (yr) | 64.4 ± 10.2 | 64.5 ± 12.3 | 0.812 |
| BMI (kg/m2) | 29.8 ± 4.9 | 29.7 ± 3.6 | 0.463 |
| Diagnosis, n (%) | 0.777 | ||
| LM | 41 (60.3) | 42 (61.8) | |
| HCC | 20 (29.4) | 17 (25.0) | |
| iCC | 7 (10.3) | 9 (13.2) | |
| ASA, n (%) | 0.328 | ||
| I | 0 | 0 | |
| II | 28 (41.2) | 24 (35.3) | |
| III | 35 (51.5) | 42 (61.8) | |
| IV | 5 (7.4) | 2 (2.9) | |
| V | 0 | 0 | |
| Previous abdominal surgery, n (%) | 23 (33.8) | 26 (38.2) | 0.592 |
| Clinical characteristics | |||
| Steatosis, n (%) | 20 (29.4) | 21 (30.9) | 0.852 |
| Fibrosis, n (%) | 21 (30.9) | 8 (11.8) | 0.006 |
| Cirrhosis, n (%) | 9 (13.2) | 12 (17.6) | 0.477 |
| Albumin (g/dL) | 4.4 ± 0.4 | 3.6 ± 0.7 | < 0.001 |
| GGT (U/L) | 85.1 ± 104.2 | 119.2 ± 219.0 | 0.326 |
| Total bilirubin (mg/dL) | 0.4 ± 0.3 | 0.9 ± 0.6 | < 0.001 |
| Platelet count (/nL) | 254.0 ± 85.4 | 230.9 ± 90.5 | 0.135 |
| Alkaline phosphatase (U/L) | 85.1 ± 34.2 | 93.8 ± 84.2 | 0.584 |
| INR | 0.98 ± 0.08 | 1.06 ± 0.07 | < 0.001 |
| Hemoglobin (g/dL) | 13.3 ± 1.7 | 13.6 ± 4.1 | 0.984 |
Table 2 Perioperative characteristics in the overweight and obese group (body mass index 25 kg/m²)
| LH vs OH | |||
| LH cohort (n = 68) | OH cohort (n = 68) | P value | |
| Operative data | |||
| Operative time (min) | 194 ± 88 | 275 ± 131 | < 0.001 |
| Major resection, n (%) | 14 (20.6) | 18 (26.5) | 0.419 |
| Operative procedure, n (%) | 0.064 | ||
| Atypical | 15 (22.1) | 23 (33.8) | |
| Segmentectomy | 11 (16.2) | 10 (14.7) | |
| Bisegmentectomy | 28 (41.2) | 17 (25.0) | |
| Left hepatectomy | 0 (0.0) | 5 (7.4) | |
| Right hepatectomy | 13 (19.1) | 13 (19.1) | |
| Extended left hepatectomy | 0 (0.0) | 1 (1.5) | |
| Conversion | 4 (5.9) | - | |
| Postoperative data | |||
| Intensive care/d | 0.8 ± 0.7 | 1.1 ± 0.8 | 0.031 |
| Hospitalization/d | 7.3 ± 3.6 | 15.7 ± 13.5 | < 0.001 |
| Blood transfusion | 12 (17.6) | 16 (23.5) | 0.396 |
| Hospital mortality, n (%) | 0 (0.0) | 3 (4.4) | 0.080 |
| Postoperative complications, n (%) | 0.065 | ||
| No complications | 54 (79.4) | 37 (54.4) | |
| Clavien-Dindo I | 4 (5.9) | 5 (7.4) | |
| Clavien-Dindo II | 5 (7.4) | 8 (11.8) | |
| Clavien-Dindo IIIa | 4 (5.9) | 8 (11.8) | |
| Clavien-Dindo IIIb | 1 (1.5) | 3 (4.4) | |
| Clavien-Dindo IVa | 0 (0.0) | 4 (5.9) | |
| Clavien-Dindo IVb | 0 (0.0) | 0 (0.0) | |
| Clavien-Dindo V | 0 (0.0) | 3 (4.4) | |
| Clavien ≥ IIIb | 1 (1.5) | 10 (14.7) | |
| Clavien ≥ I | 14 (20.6) | 31 (45.6) | |
| Biliary leakage | 1 (1.5) | 10 (14.7) | 0.005 |
| Liver failure | 0 (0.0) | 4 (5.9) | 0.042 |
| Surgical site infections | 2 (2.9) | 6 (8.8) | 0.145 |
| Pneumonia | 0 (0.0) | 6 (8.8) | 0.012 |
| CCI | 3.9 ± 9.1 | 15.4 ± 23.6 | 0.000 |
| Estimated cost (€) | 10060 ± 1537 | 11789 ± 5973 | 0.779 |
Table 3 Perioperative characteristics in the obese group (body mass index 30 kg/m²)
| LH vs OH | |||
| LH cohort (n = 27) | OH cohort (n = 29) | P value | |
| Operative data | |||
| Operative time (min) | 194 ± 81 | 260 ± 137 | 0.009 |
| Major resection, n (%) | 5 (18.5) | 5 (17.2) | 0.901 |
| Operative procedure, n (%) | 0.257 | ||
| Atypical | 7 (25.9) | 8 (27.6) | |
| Segmentectomy | 4 (14.8) | 7 (24.1) | |
| Bisegmentectomy | 11 (40.7) | 9 (31.0) | |
| Left hepatectomy | 0 (0.0) | 3 (10.3) | |
| Right hepatectomy | 5 (18.5) | 2 (6.9) | |
| Conversion | 2 (7.4) | - | |
| Postoperative data | |||
| Intensive care/d | 0.7 ± 0.4 | 1.0 ± 0.8 | 0.240 |
| Hospitalization/d | 7.7 ± 4.3 | 17.2 ± 17 | < 0.001 |
| Blood transfusion | 3 (11.1) | 8 (27.6) | 0.121 |
| Hospital mortality, n (%) | 0 (0.0) | 0 (0.0) | 0.080 |
| Postoperative complications, n (%) | 0.562 | ||
| No complications | 19 (70.4) | 17 (58.6) | |
| Clavien-Dindo I | 3 (11.1) | 2 (6.9) | |
| Clavien-Dindo II | 1 (3.7) | 2 (6.9) | |
| Clavien-Dindo IIIa | 3 (11.1) | 3 (10.3) | |
| Clavien-Dindo IIIb | 1 (3.7) | 2 (6.9) | |
| Clavien-Dindo IVa | 0 (0.0) | 3 (10.3) | |
| Clavien-Dindo IVb | 0 (0.0) | 0 (0.0) | |
| Clavien-Dindo V | 0 (0.0) | 0 (0.0) | |
| Clavien ≥ IIIb | 1 (3.7) | 5 (17.2) | 0.102 |
| Clavien ≥ I | 8 (29.6) | 12 (41.4) | 0.359 |
| Biliary leakage | 1 (3.7) | 3 (10.3) | 0.335 |
| Liver failure | 0 (0.0) | 2 (6.9) | 0.165 |
| Surgical site infections | 2 (7.4) | 4 (13.8) | 0.440 |
| Pneumonia | 0 (0.0) | 0 (0.0) | - |
| CCI | 5.4 ± 11.1 | 12.3 ± 16.8 | 0.132 |
| Estimated cost (€) | 10111 ± 1748 | 11021 ± 3133 | 0.710 |
- Citation: Heise D, Bednarsch J, Kroh A, Schipper S, Eickhoff R, Coolsen M, Van Dam R, Lang S, Neumann U, Ulmer F. Laparoscopic hepatectomy reduces postoperative complications and hospital stay in overweight and obese patients. World J Gastrointest Surg 2021; 13(1): 19-29
- URL: https://www.wjgnet.com/1948-9366/full/v13/i1/19.htm
- DOI: https://dx.doi.org/10.4240/wjgs.v13.i1.19