Obesity and its influence on liver dysfunction,morbidity and mortality after liver resection

Background:Obesity and associated steatosis is an increasing health problem worldwide.Its influence on post-hepatectomy liver failure(PHLF)and after liver resection(LR)is still unclear.Methods:Patients who underwent LR were investigated and divided into three groups[normal weight:body mass index(BMI)18.5-24.9 kg/m2,overweight:BMI 25.0-29.9 kg/m2,obese:BMI≥30 kg/m2]in this retrospective study.Primary aim of this study was to assess the influence of BMI and nonalcoholic steatohepatitis(NASH)on PHLF and morbidity.Results:Of 888 included patients,361(40.7%)had normal weight,360(40.5%)were overweight,167(18.8%)were obese.Median age was 62.5 years(IQR,54-69 years).The primary indication for LR was colorectal liver metastases(CLM)(n=366,41.2%).NASH was present in 58(16.1%)of normal weight,84(23.3%)of overweight and 69(41.3%)of obese patients(P<0.001).PHLF occurred in 16.3%in normal weight,15.3%in overweight and 11.4%in obese patients(P=0.32).NASH was not associated with PHLF.There was no association between patients’weight and the occurrence of postoperative complications(P=0.45).At multivariable analysis,solely major LR[odds ratio(OR):2.7,95%confidence interval(CI):1.83-4.04;P<0.001]remained a significant predictor for PHLF.Conclusions:Postoperative complications and PHLF are comparable in normal weight,overweight and obese patients and LRs using modern techniques can be safely performed in these patients.