Effect of Obesity on Perioperative Outcomes after Laparoscopic Hepatectomy

Aim: Laparoscopic hepatectomy is increasing in utilization, however the procedure has not been adequately examined in the obese patient.This study aims to analyze the effect of obesity on perioperative outcomes after laparoscopic hepatectomy.Methods: Retrospective analysis of 396 laparoscopic hepatectomies in normal [body mass index (BMI) < 25], overweight (BMI ≥ 25), obese (BMI ≥ 30), and severely obese (BMI ≥ 35) patients using multivariate regression models to determine the risk factors for post-operative complications.Results: Normal BMI (n = 78; 20%), overweight (n = 209; 52%), obese (n = 86; 22%), and severely obese (n = 23; 6%).Demographics were similar except for a higher American Society of Anesthesiologists (ASA) score in the obese group.Estimated blood loss and operating time were greatest in the overweight group, while length of stay and complications were statistically similar between groups.Univariate analysis identified that complications were associated with weight class, ASA score, blood loss, and resection; multivariate analysis revealed ASA and transfusion were best correlated with complications.Conclusion: Obese and overweight patients have similar complication profiles to normal BMI patients while severely obese patients have a higher incidence of complications that are primarily limited to Clavien-Dindo class I and II.