INCIDENTAL INTRAOPERATIVE DISCOVERY OF LIVER CIRRHOSIS DURING LAPAROSCOPIC BARIATRIC SURGERY: PREVALENCE AND MANAGEMENT OUTCOMES
Keywords:
Bariatric surgery, liver cirrhosis, incidental findings, laparoscopic sleeve gastrectomy, one anastomosis gastric bypass, surgical outcomesAbstract
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.
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References
Mosko JD, Nguyen GC. Increased perioperative mortality following bariatric surgery among patients with cirrhosis. Clin Gastroenterol Hepatol. 2011;9(10):897-901. https://doi.org/10.1016/j.cgh.2011.07.007
Jan A, Narwaria M, Mahawar KK. A systematic review of bariatric surgery in patients with liver cirrhosis. Obes Surg. 2015;25(8):1518-26. https://doi.org/10.1007/s11695-015-1727-2
Wolter S, Duprée A, Coelius C, et al. Influence of liver disease on perioperative outcome after bariatric surgery in a northern German cohort. Obes Surg. 2017;27(1):90-95. https://doi.org/10.1007/s11695-016-2253-6
