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Comparative Study
. 2024 Dec;54(12):1461-1471.
doi: 10.1007/s00595-024-02865-3. Epub 2024 Jun 14.

Positive impact of laparoscopic hepatectomy versus open hepatectomy on body size-corrected bleeding in obese patients

Masanori Nakamura  1   2 , Ryo Ashida  3 , Katsuhisa Ohgi  1 , Mihoko Yamada  1 , Yoshiyasu Kato  1 , Shimpei Otsuka  1 , Yuko Kakuda  4 , Katsuhiko Uesaka  1 , Teiichi Sugiura  1
Affiliations
Comparative Study

Positive impact of laparoscopic hepatectomy versus open hepatectomy on body size-corrected bleeding in obese patients

Masanori Nakamura et al. Surg Today. 2024 Dec.

Abstract

Purpose: Laparoscopic hepatectomy (LH) is reported to cause less bleeding than open hepatectomy (OH) in obese patients; however, there are no reports addressing this issue in terms of body size-corrected bleeding.

Methods: The subjects of this study were 31 obese and 149 non-obese patients who underwent LH and 32 obese and 245 non-obese patients who underwent OH. Bleeding corrected for body surface area (C-BL) was compared between the obese and non-obese patients who underwent each procedure. A multivariate analysis for increased C-BL was performed using the median C-BL for each procedure.

Results: The median C-BL tended to be higher in the obese patients than in the non-obese patients who underwent LH, but there was no significant difference (72 vs. 42 mL/m2, P = 0.050). However, it was significantly higher in the obese patients than in the non-obese patients who underwent OH (542 vs. 333 mL/m2, P = 0.002). In a multivariate analysis, for OH, sectionectomy or more (OR 3.20, P < 0.001) and a high BMI (OR 2.76, P = 0.018) were found to be independent risk factors, whereas for LH, a high BMI was not (OR 1.58, P = 0.301).

Conclusions: Obesity was identified as a risk factor for increased bleeding with body size correction for OH, but the risk was reduced for LH.

Keywords: Body mass index; Body size correction; Intraoperative bleeding; Laparoscopic hepatectomy; Obesity.

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Conflict of interest statement

Declarations. Conflict of interest: We have no conflicts of interest to declare in association with the publication of this article.

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