Jan Ahmad, Narwaria Mahendra, Mahawar Kamal K
Asian Bariatric Hospital, Ahemdabad, Gujarat, India.
Obes Surg. 2015 Aug;25(8):1518-26. doi: 10.1007/s11695-015-1727-2.
Nonalcoholic steatohepatitis is becoming a common cause of liver cirrhosis and a significant number of patients undergoing bariatric surgery suffer with it. There is currently lack of consensus among surgeons regarding safety of bariatric surgery in patients with liver cirrhosis and the best bariatric procedure in these patients. This review investigates published English language scientific literature systematically in an attempt to answer these questions. Eleven studies that reported experience of bariatric surgery in cirrhotic obese patients were included in this review. This review shows an acceptably higher overall risk of complications and perioperative mortality with bariatric surgery in cirrhotic patients. Surgeons must discuss the possibility of an unexpected intraoperative diagnosis of cirrhosis preoperatively with all bariatric surgery patients and agree on a course of action.
非酒精性脂肪性肝炎正成为肝硬化的常见病因，大量接受减肥手术的患者患有此病。目前，外科医生对于肝硬化患者进行减肥手术的安全性以及此类患者的最佳减肥手术方式尚未达成共识。本综述系统地调查了已发表的英文科学文献，试图回答这些问题。本综述纳入了11项报告肥胖肝硬化患者减肥手术经验的研究。该综述表明，肝硬化患者接受减肥手术时，并发症和围手术期死亡率的总体风险较高，但仍可接受。外科医生必须在术前与所有减肥手术患者讨论术中意外诊断为肝硬化的可能性，并商定行动方案。
