• Laurent Genser, Chetana Lim, Louise Barbier, Jean-Marc Regimbeau, Christian Hobeika, Claire Goumard, Alexis Laurent, David Fuks, Laurence Chiche, Eric Vibert, Olivier Scatton, and AFC-LLR-2018 Study Group.
• From the Sorbonne Université, Department of Hepato-Pancreato-Biliary Surgery and Liver Transplantation, AP-HP Pitie-Salpetriere Hospital, Paris, France (Genser, Lim, Goumard, Scatton).
• J. Am. Coll. Surg. 2022 Aug 1; 235 (2): 159171159-171.

BackgroundLiver surgeons need to know the expected outcomes of laparoscopic liver resection (LLR) in obese patients.ObjectiveThe purpose of the present study is to assess morbidity, mortality and textbook outcomes (TO) after LLR in obese patients.MethodsThis is a French multicenter study of patients undergoing LLR between 1996 and 2018. Obesity was defined by a BMI at or above 30 kg/m 2 . Short-term outcomes and TO were compared between obese (ob) and nonobese (non-ob) patients. Factors associated with severe morbidity and TO were investigated.ResultsOf 3,154 patients included, 616 (19.5%) were obese. Ob-group patients had significantly higher American Society of Anesthesiologists (ASA) score and higher incidence of metabolic syndrome and chronic liver disease and were less likely to undergo major hepatectomy. Mortality rates were similar between ob and non-ob groups (0.8 vs 1.1%; p = 0.66). Overall morbidity and hospital stay were significantly increased in the ob group compared with the non-ob group (39.4 vs 34.7%, p = 0.03; and 9.5 vs 8.6 days, p = 0.02), whereas severe 90-day morbidity (at or above Clavien-Dindo grade III) was similar between groups (8% in both groups; p = 0.90). TO rate was significantly lower for the ob group than the non-ob group (58.3 vs 63.7%; p = 0.01). In multivariate analysis, obesity did not emerge as a risk factor for severe 90-day morbidity but was associated with a lower TO rate after LLR (odds ratio = 0.8, 95% CI 0.7-1.0; p = 0.03).ConclusionsLLR in obese patients is safe and effective with acceptable mortality and morbidity. Obesity had no impact on severe morbidity but was a factor for failing to achieve TO after LLR.Copyright © 2022 by the American College of Surgeons. Published by Wolters Kluwer Health, Inc. All rights reserved.

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