Laparoscopic Sleeve Gastrectomy After Orthotopic Liver Transplantation, Video Reported
- PDF / 360,413 Bytes
- 3 Pages / 595.276 x 790.866 pts Page_size
- 22 Downloads / 203 Views
VIDEO SUBMISSION
Laparoscopic Sleeve Gastrectomy After Orthotopic Liver Transplantation, Video Reported Georges Bou Nassif 1
&
Chady Salloum 2 & Luca Paolino 1 & Daniel Azoulay 2 & Andrea Lazzati 1
# Springer Science+Business Media, LLC, part of Springer Nature 2019
Abstract Introduction The immunosuppressive therapy for life after liver transplantation (LT) is considered as a risk factor for obesity. Seven percent of the transplanted patients develop severe or morbid obesity. The obesity induces non-alcoholic steatohepatitis (NASH), which is a major risk factor for liver cirrhosis and hepatocellular carcinoma, without forgetting the cardiovascular risk and the devastating impact of obesity on quality of life of the transplanted patients. Consequently, obesity exposes these patients to future transplant loss. Bariatric surgery has been proposed for transplant patients to reduce the obesity-related comorbidities and to improve survival. We report in this video the surgical technique of laparoscopic sleeve gastrectomy (LSG) after LT. Methods We have performed between 2008 and 2017 the sleeve gastrectomy (SG) after LT in nine patients. Six procedures (66%) were performed totally by laparoscopy and three by upfront laparotomy. All the patients had a standard preoperative evaluation for obesity. All the procedures were assisted by a hepatic surgeon. Postoperatively patients were transferred to the liver ICU for 24 h then to the liver unit ward. Result The median BMI was 41.9 kg/m2 (range 38–46.1 kg/m2). Median operative time was 120 min (range, 90–240 min). No intra-operative complications occurred. The median length of hospital stay was 7 days (range, 4–81 days). The postoperative course of the majority of the patients was uneventful except for one patient who develops a staple line leak. Conclusion LSG after LT is technically feasible. Larger series are needed to improve the safety of the procedure in this high-risk population. Keywords Steatohepatitis . Bariatric surgery . Sleeve gastrectomy . Liver transplantation Electronic supplementary material The online version of this article (https://doi.org/10.1007/s11695-019-03751-5) contains supplementary material, which is available to authorized users. * Georges Bou Nassif [email protected] Chady Salloum [email protected] Luca Paolino [email protected] Daniel Azoulay [email protected] Andrea Lazzati [email protected] 1
Department of General Surgery, Center Hospitalier Intercommunal de Créteil, 40 Avenue de Verdun, 94000 Créteil, France
2
Service de Chirurgie Digestive, Hépato-Biliaire, Hôpital Henri-Mondor - AP-HP, 51 Avenue du Maréchal de Lattre de Tassigny, 94000 Créteil, France
Introduction The immunosuppressive therapy for life after liver transplantation (LT) is considered as a risk factor for obesity. The prevalence of severe and morbid obesity of patients who received LT is around 7 % [1]. The obesity and some of its comorbidities, such as diabetes type 2, induce non-alcoholic steatohepatitis (NASH), which is a major r
Data Loading...
