Laparoscopic hepatectomy in a morbidly obese patient with liver cirrhosis: A case report
- Nikolaos Machairas
- Ioannis D. Kostakis
- Dimitrios Mantas
- Georgios C. Sotiropoulos
Published online on: Tuesday, December 13, 2016
Cirrhotic patients constitute a high‑risk population, and present a major challenge for the performance of minimally invasive laparoscopic resections due to difficulties in parenchymal transection. The present study describes the case of a 71‑year‑old morbidly obese male patient who was referred to our department with a hepatic mass identified on routine abdominal ultrasound. Abdominal computer tomography and magnetic resonance imaging confirmed a mass in segments V‑VI of the liver, highly suspicious for HCC. The patient's past medical history additionally included non‑alcoholic steatohepatitis, diabetes mellitus and arterial hypertension and myocardial infarction. The patient's body mass index was 45 kg/m2, and the American Society of Anesthesiologists' classification of preoperative risk was 3. The patient underwent laparoscopic resection of segments V‑VI and cholecystectomy. Two years postoperatively, the patient remains disease‑free and in excellent condition. To the best of our knowledge, this is the first report on laparoscopic liver resection for such a morbidly obese patient in the context of advanced liver cirrhosis.