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Laparoscopic Sleeve Gastrectomy for Morbid Obesity in Patients After Orthotopic Liver Transplant: a Matched Case-Control Study

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Abstract

Introduction

Obesity is frequently encountered in patients with orthotopic liver transplant (OLT). The role of bariatric surgery is still unclear for this specific population. The aim of this study was to review our experience with laparoscopic sleeve gastrectomy (LSG) after OLT.

Material and Methods

We performed a retrospective case-control study of patients undergoing LSG after OLT from 2010 to 2016. OLT-LSG patients were matched by age, sex, body mass index (BMI), and year to non-OLT patients undergoing LSG. Demographics, operative variables, postoperative events, and long-term weight loss with comorbidity resolution were collected and compared between cases and controls.

Results

Of 303 patients undergoing LSG, 12 (4%) had previous OLT. They were matched to 36 non-OLT patients. No difference was found between groups in the American Society of Anesthesiologists class, mean operative time, or postoperative morbidity. The non-OLT group, however, had a significantly shorter mean hospital stay than the OLT group (1.7 vs 3.1 days; P < .001). There were no conversions to open procedures. For patients with long-term follow-up, change in BMI after LSG was similar between the groups, but the non-OLT patients had significantly more excess body weight loss at 2 years (53.7 vs 45.2%; P < .001). Similar resolution of comorbid conditions was noted in both groups. LSG caused no changes in dosage of immunosuppressive medications, and no liver complications occurred.

Conclusion

LSG after OLT in appropriately selected patients appears to have similar outcomes to LSG in non-OLT patients.

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Abbreviations

BMI:

body mass index

EBWL:

excess body weight loss

LSG:

laparoscopic sleeve gastrectomy

NASH:

non-alcoholic steatohepatitis

OLT:

orthotopic liver transplant

RYGB:

Roux-en-Y gastric bypass

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Authors and Affiliations

  1. Department of Surgery, Mayo Clinic, 4500 San Pablo Rd, Jacksonville, FL, 32224, USA

    Levan Tsamalaidze, John A. Stauffer, Lisa C. Arasi, Diego E. Villacreses, Steven Bowers & Enrique F. Elli

  2. Department of Surgery, Hospital de Especialidades Centro Medico Nacional Siglo XXI, Mexico City, Mexico

    Jose Salvador Serrano Franco

Authors
  1. Levan Tsamalaidze
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  2. John A. Stauffer
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  3. Lisa C. Arasi
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  4. Diego E. Villacreses
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  5. Jose Salvador Serrano Franco
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  6. Steven Bowers
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  7. Enrique F. Elli
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Corresponding author

Correspondence to John A. Stauffer.

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For this type of study, formal consent is not required.

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Does not apply

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The authors declare that they have no conflict of interest.

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Tsamalaidze, L., Stauffer, J.A., Arasi, L.C. et al. Laparoscopic Sleeve Gastrectomy for Morbid Obesity in Patients After Orthotopic Liver Transplant: a Matched Case-Control Study. OBES SURG 28, 444–450 (2018). https://doi.org/10.1007/s11695-017-2847-7

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  • DOI: https://doi.org/10.1007/s11695-017-2847-7

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