The impact of obesity on short-term outcomes after the laparoscopic liver resection: a single-institution experience

Introduction
Obesity is a major public health problem and a well-known cause of multiple comorbidities. With the increasing application of minimally invasive surgery for benign and malignant liver lesions, the results of laparoscopic liver resection (LLR) in obese patients are of great interest.

Aim
To evaluate the short-term operative outcomes after LLR in obese patients and compare them to patients with normal weight and overweight.

Material and methods
All 235 consecutive patients undergoing LLR from 2008 to 2023 were retrospectively analysed. Patients were categorized into 3 groups based on their body mass index (BMI): normal weight (18.5–24.9 kg/m2), overweight (25–29.9 kg/m2), and obese (≥ 30 kg/m2). The groups were then compared regarding preoperative data and intra- and postoperative outcomes.

Results
Despite higher ASA score and associated comorbidities in the obese group, there were no significant differences in intraoperative complication (blood loss, damage to surrounding structures, conversion rate) between BMI groups (20.8% vs. 16.8% vs. 22.7%, p = 0.619). There were no significant differences in overall morbidity (34.7% vs. 27.7% vs. 29.5%, p = 0.582), as well as major morbidity (15.9% vs. 11.8% vs. 11.4%, p = 0.784) or mortality rates (1.4% vs. 1.7% vs. 0.0%, p = 1.000). Univariate logistic regression did not show BMI or obesity as a predictive variable for intraoperative complication.

Conclusions
Obesity is not a significant, strong risk factor for worse short-term outcomes, and LLR may be considered also in patients with overweight and obesity.