Abstract
Background: Data on outcomes of bariatric surgery in cirrhotic patients is limited. Aim: To assess safety and metabolic or liver related outcomes after bariatric surgery in patients with known cirrhosis ± portal hypertension. Methods: 14 patients with known Child's A cirrhosis ± portal hypertension with 6 months to 2 years followup were included (11 sleeve gastrectomy, 3 gastric bypass). Results: Mean age 55.5 years, 10/14 female. 14/14 with NASH (2 with HCV and NASH). 3 patients had portal hypertension on EGD (2 portal gastropathy, 1 small varices). Mean weight decreased from 125 ± 18 kg pre-op to 94 ± 17kg and 80 ± 38kg by 1 (p 30% steatosis). Bilirubin increased above 2mg/dL in 1 patient after 1 year post-op. One patient developed encephalopathy 3 years post-op. No patients developed post-operative bleeding or surgical complications. Conclusion: Bariatric surgery in patients with well compensated cirrhosis is well tolerated with beneficial effects of weight loss and metabolic syndrome improvement as well as reduced hepatic steatosis. No bleeding complications were noted in the few patients with mild endoscopic portal hypertension.
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