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Obesity Surgery

, Volume 29, Issue 2, pp 585–592 | Cite as

Outcomes of Bariatric Surgery in Patients with Cirrhosis

  • Inka MiñambresEmail author
  • Miguel Angel Rubio
  • Ana de HollandaEmail author
  • Irene Breton
  • Nuria Vilarrasa
  • Silvia Pellitero
  • Marta Bueno
  • Albert Lecube
  • Clara Marcuello
  • Albert Goday
  • Maria D. Ballesteros
  • German Soriano
  • Assumpta Caixàs
Original Contributions

Abstract

Context

Information concerning the risk–benefit profile of bariatric surgery in subjects with liver cirrhosis is scarce. Our aim was to describe the long-term outcomes of bariatric surgery in a cohort of patients with liver cirrhosis submitted to bariatric surgery.

Methods

This was a multicenter, retrospective observational study performed by the Obesity Group of the Spanish Society of Endocrinology and Nutrition (GOSEEN), with a review of patients with cirrhosis who had undergone bariatric surgery during the period from April 2004 to March 2017 in ten public reference hospitals in Spain.

Results

Data on 41 patients with cirrhosis submitted to obesity surgery were collected (mean age 53.8 ± 7.9 years, 46.3% women, presurgical BMI 45 ± 8.3 kg/m2). All but one patient belonged to Child–Pugh class A, and sleeve gastrectomy was conducted in 68.3% of cases. Percentage of total weight loss (%TWL) was 26.33 ± 8.3% and 21.16 ± 15.32% at 1 and 5 years after surgery, respectively. This was accompanied by a significant reduction of type 2 diabetes, high blood pressure, and dyslipidemia and by an improvement of liver enzymes over time. Model for End-Stage Liver Disease (MELD) index increased from 7.2 ± 1.9 to 9.8 ± 4.6 after 5 years. Seven patients (17%) developed early postsurgical complications. No postsurgical mortality was observed. During follow-up, only five patients developed liver decompensation.

Conclusions

Bariatric surgery in selected patients with liver cirrhosis has metabolic benefits that could have a positive impact on liver prognosis.

Trial Registration

Controlledtrials.com Identifier: 10.1186/ISRCTN15009106

Keywords

Obesity surgery Liver Cirrhosis 

Notes

Acknowledgments

We would like to thank The Obesity Group of the Spanish Society of Endocrinology and Nutrition (GOSEEN) for participating and providing data for this study. The authors thank Martin Price for his valuable help with the English version of the manuscript.

Compliance with Ethical Standards

Conflict of Interest

The authors declare that they have no conflict of interest.

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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  • Inka Miñambres
    • 1
    • 2
    Email author
  • Miguel Angel Rubio
    • 3
  • Ana de Hollanda
    • 4
    Email author
  • Irene Breton
    • 5
  • Nuria Vilarrasa
    • 6
    • 7
  • Silvia Pellitero
    • 7
    • 8
  • Marta Bueno
    • 9
  • Albert Lecube
    • 7
    • 9
  • Clara Marcuello
    • 3
  • Albert Goday
    • 2
    • 10
    • 11
  • Maria D. Ballesteros
    • 12
  • German Soriano
    • 2
    • 13
    • 14
  • Assumpta Caixàs
    • 15
  1. 1.Endocrinology and Nutrition DepartmentHospital de La Santa Creu i Sant PauBarcelonaSpain
  2. 2.Medicine DepartmentUniversitat Autònoma de BarcelonaBarcelonaSpain
  3. 3.Endocrinology and Nutrition Department. Hospital Clínico San Carlos. IDISSC. Facultad de MedicinaUniversidad ComplutenseMadridSpain
  4. 4.Obesity UnitHospital Clínic UniversitariBarcelonaSpain
  5. 5.Endocrinology and Nutrition DepartmentHospital General Universitario Gregorio MarañónMadridSpain
  6. 6.Department of Endocrinology and NutritionBellvitge University Hospital-IDIBELLBarcelonaSpain
  7. 7.CIBER de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM)Instituto de Salud Carlos IIIMadridSpain
  8. 8.Department of Endocrinology and NutritionGermans Trias i Pujol University Hospital-IGTPBarcelonaSpain
  9. 9.Endocrinology and Nutrition Department, University Hospital Arnau de Vilanova. Obesity, Diabetes and Metabolism (ODIM) Research Group, IRBLleidaUniversity of LleidaLleidaSpain
  10. 10.Endocrinology and Nutrition DepartmentHospital del MarBarcelonaSpain
  11. 11.Centro de Investigaciones Biomédicas en Red de Obesidad y Nutrición, CIBERobnMadridSpain
  12. 12.Endocrinology and Nutrition DepartmentComplejo Asistencial Universitario de LeónLeonSpain
  13. 13.Department of GastroenterologyHospital de la Santa Creu i Sant PauBarcelonaSpain
  14. 14.CIBERehd, Instituto de Salud Carlos IIIMadridSpain
  15. 15.Department of Endocrinology and NutritionParc Taulí University Hospital, UABSabadellSpain

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