Abstract
Introduction
Currently, the impact of body mass index (BMI) on the outcomes of laparoscopic liver
resections (LLR) is poorly defined. This study attempts to evaluate the impact of
BMI on the peri-operative outcomes following laparoscopic left lateral sectionectomy
(L-LLS).
Methods
A retrospective analysis of 2183 patients who underwent pure L-LLS at 59 international
centers between 2004 and 2021 was performed. Associations between BMI and selected
peri-operative outcomes were analyzed using restricted cubic splines.
Results
A BMI of >27kg/m2 was associated with increased in blood loss (Mean difference (MD)
21 mls, 95% CI 5–36), open conversions (Relative risk (RR) 1.13, 95% CI 1.03–1.25),
operative time (MD 11 min, 95% CI 6–16), use of Pringles maneuver (RR 1.15, 95% CI
1.06–1.26) and reductions in length of stay (MD -0.2 days, 95% CI -0.3 to −0.1). The
magnitude of these differences increased with each unit increase in BMI. However,
there was a “U” shaped association between BMI and morbidity with the highest complication
rates observed in underweight and obese patients.
Conclusion
Increasing BMI resulted in increasing difficulty of L-LLS. Consideration should be
given to its incorporation in future difficulty scoring systems in laparoscopic liver
resections.
Keywords
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Article info
Publication history
Published online: May 02, 2023
Accepted:
March 30,
2023
Received in revised form:
March 19,
2023
Received:
January 25,
2023
Publication stage
In Press Journal Pre-ProofIdentification
Copyright
© 2023 Elsevier Ltd, BASO ~ The Association for Cancer Surgery, and the European Society of Surgical Oncology. All rights reserved.
