Uchida H, Iwashita Y, Saga K, Takayama H, Watanabe K, Endo Y, Yada K, Ohta M, Inomata M. Benefit of laparoscopic liver resection in high body mass index patients. World J Gastroenterol 2016; 22(10): 3015-3022 [PMID: 26973397 DOI: 10.3748/wjg.v22.i10.3015]
Corresponding Author of This Article
Hiroki Uchida, MD, PhD, Department of Gastroenterological and Pediatric Surgery, Oita University Faculty of Medicine, 1-1 Hasama-machi, Yufu, Oita 879-5593, Japan. ucchy@oita-u.ac.jp
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Retrospective Study
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Gastroenterol. Mar 14, 2016; 22(10): 3015-3022 Published online Mar 14, 2016. doi: 10.3748/wjg.v22.i10.3015
Table 1 Comparison of patients’ characteristics and surgical outcomes n (%)
LLR (n = 39)
OLR (n = 29)
P value
Age (yr)
69.4 ± 10.2
68.3 ± 8.1
NS
Sex (Male/Female)
26/13
22/7
NS
HBV
6 (15.4)
4 (13.8)
NS
HCV
19 (48.7)
13 (44.8)
NS
Diagnosis
Hepatocellular carcinoma
33 (84.6)
22 (75.9)
Intrahepatic cholangiocarcinoma
2 (5.1)
1 (3.4)
Metastatic liver tumor
2 (5.1)
6 (20.7)
Hemangioma
2 (5.1)
0
Body mass index (kg/m2)
24.1 ± 4.1
23.9 ± 3.9
NS
Tumor size (mm)
27.3 ± 14.5
27.6 ± 11.6
NS
Surgical outcome
Operation time (min)
226.1 ± 117.2
292.8 ± 86.7
0.009
Blood loss (mL)
109.3 ± 162.0
406.9 ± 425.6
0.001
Postoperative hospital stay (d)
12.8 ± 10.4
23.6 ± 30.1
0.042
Overall morbidity
4 (10.2)
7 (24.1)
NS
Grade I
0
1
Grade II
3
4
Grade III (a/b)
1/0
1/1
Grade IV
0
0
Grade V
0
0
Bile leakage
1 (2.7)
2 (6.9)
NS
Table 2 Comparison of patients’ characteristics and surgical outcomes in patients with obesity
LLR (n = 12)
OLR (n = 10)
P value
Patients’ characteristics
Age
70.5 ± 9.4
67.1 ± 6.2
NS
Sex (Male/Female)
7/5
10/0
0.020
HBV
1
2
NS
HCV
7
2
NS
Body mass index (kg/m2)
29.0 ± 3.7
28.2 ± 2.3
NS
Tumor size (mm)
23.8 ± 8.7
26.0 ± 11.6
NS
Liver weight (g)
47.1 ± 35.5
60.8 ± 61.2
NS
Surgical outcome
Operation time (min)
241.3 ± 97.6
346.7 ± 83.8
0.014
Blood loss (mL)
128.3 ± 193.1
635.5 ± 655.1
0.039
Postoperative hospital stay (d)
11.6 ± 3.3
20.8 ± 15.4
0.094
Complication, n (%)
1 (8.3)
1 (10)
NS
Biloma
0
0
NS
Table 3 Univariate and multivariate analysis on prolonged operation time
Operation time
Univariate
Multivariate
< 200
≥200
P value
P value
OR (95%CI)
Number of patients
25
43
Age (yr)
71.5 ± 8.4
67.4 ± 9.6
0.082
Sex (Male/Female)
16/9
32/11
0.363
Body mass index (kg/m2)
22.7 ± 2.6
24.8 ± 4.5
0.019
0.024
1.259 (1.031-1.538)
HBV
2
8
0.304
HCV
12
20
0.906
Open liver resection < 0.001
3
26
< 0.001
< 0.001
16.244 (3.648-72.340)
Tumor size (mm)
23.3 ± 9.9
29.8 ± 14.4
0.049
0.047
1.056 (1.001-1.114)
Total bilirubin (mg/dL)
0.77 ± 0.28
0.79 ± 0.31
0.829
Albumin (g/dL)
3.94 ± 0.59
3.91 ± 0.46
0.848
Prothrombin time (%)
101.4 ± 21.9
98.2 ± 17.2
0.508
Indocyanine green (%)
11.8 ± 11.1
18.9 ± 14.8
0.042
Aspartate transaminase (U/L)
36.8 ± 20.5
39.1 ± 20.9
0.669
Alanine transaminase (U/L)
30.2 ± 22.8
33.3 ± 22.3
0.596
γ-glutamy transpeptidase (U/L)
57.5 ± 48.3
64.8 ± 51.3
0.567
Alkaline phosphatase (U/L)
315.6 ± 109.9
306.0 ± 105.5
0.725
Cholinesterase (U/L)
176.6 ± 127.0
188.5 ± 115.3
0.649
White blood cell (/mm3)
4342 ± 1383
4638 ± 1748
0.470
Hemoglobin (g/dL)
12.8 ± 1.9
13.1 ± 2.1
0.598
Hematocrit (%)
36.9 ± 7.3
39.0 ± 5.6
0.185
Platelet count (× 103/mm3)
14.5 ± 7.7
13.2 ± 6.0
0.433
Table 4 Univariate and multivariate analysis on increased blood loss
Blood loss
Univariate
Multivariate
< 215
≥215
P value
P value
OR (95%CI)
Number of patients
40
28
Age (yr)
68.5 ± 10.1
68.1 ± 4.5
0.558
Sex (Male/Female)
26/14
22/6
0.227
Body mass index (kg/m2)
23.1 ± 3.4
25.3 ± 4.5
0.027
0.035
1.233 (1.015-1.498)
HBV
4
6
0.297
HCV
20
12
0.561
Open liver resection
8
21
< 0.001
< 0.001
27.736 (5.926-129.811)
Tumor size (mm)
26.0 ± 11.4
29.4 ± 15.5
0.303
Total bilirubin (mg/dL)
0.76 ± 0.30
0.81 ± 0.30
0.490
Albumin (g/dL)
3.98 ± 0.55
3.84 ± 0.43
0.287
Prothrombin time (%)
103.2 ± 20.3
93.9 ± 15.6
0.046
0.030
0.947 (0.902-0.995)
Indocyanine green (%)
13.4 ± 10.7
20.3 ± 16.9
0.044
Aspartate transaminase (U/L)
34.3 ± 19.8
43.9 ± 20.7
0.056
Alanine transaminase (U/L)
28.3 ± 19.6
37.6 ± 25.2
0.955
γ-glutamy transpeptidase (U/L)
52.6 ± 50.1
75.7 ± 47.4
0.060
Alkaline phosphatase (U/L)
310.1 ± 107.1
308.6 ± 107.3
0.955
Cholinesterase (U/L)
178.9 ± 130.0
191.6 ± 103.0
0.669
White blood cell (/mm3)
4339 ± 1540
4802 ± 1716
0.249
Hemoglobin (g/dL)
12.8 ± 1.9
13.4 ± 2.2
0.218
Hematocrit (%)
37.0 ± 6.5
40.0 ± 5.7
0.056
Platelet count (× 103/mm3)
14.7 ± 7.6
12.3 ± 4.6
0.114
Citation: Uchida H, Iwashita Y, Saga K, Takayama H, Watanabe K, Endo Y, Yada K, Ohta M, Inomata M. Benefit of laparoscopic liver resection in high body mass index patients. World J Gastroenterol 2016; 22(10): 3015-3022