INCIDENTAL INTRAOPERATIVE DISCOVERY OF LIVER CIRRHOSIS DURING LAPAROSCOPIC BARIATRIC SURGERY: PREVALENCE AND MANAGEMENT OUTCOMES

Abstract

This retrospective study analyzed 629 consecutive patients undergoing laparoscopic bariatric surgery between 2023-2024 to evaluate incidental liver cirrhosis discovery rates and management strategies. Unexpected cirrhosis was identified intraoperatively in 39 patients (6.2%) despite standard preoperative screening including liver function tests and abdominal ultrasound. Surgical modification was required in 30.8% of cases, with 6 conversions from gastric bypass to sleeve gastrectomy and 6 procedures abandoned. Cirrhotic patients experienced significantly higher morbidity (10.2% vs standard rates), one mortality (2.5%), and prolonged hospitalization (7.2 vs 2.8 days, p<0.001). These findings highlight critical gaps in preoperative hepatic assessment and emphasize the urgent need for enhanced diagnostic protocols and standardized intraoperative management guidelines for unexpected cirrhosis during bariatric procedures.