ArticleSurgery2023
Impact of body mass index on perioperative outcomes of laparoscopic major hepatectomies.
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Article in Surgery, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.
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6citing papers in PubMed
1.5field-weighted citation impact, top 17% of its field
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6 citing papers in PubMed, 7 citations in OpenAlex.
- Current difficulty scoring systems may underestimate the technical complexity of segment 6 laparoscopic hepatectomy in patients with hepatocellular carcinoma.Surgical endoscopy · 2026Article
- From prediction to judgment: what a five-variable nomogram teaches us about hepatocellular carcinoma.Journal of gastrointestinal oncology · 2026Article
- Minimally invasive vs. open hepatectomy in patients with obesity and liver tumors: a systematic review and meta-analysis.Frontiers in surgery · 2026Review
- Comparison of robotic liver resection in obese vs. non-obese patients: a multicentric propensity score-matched analysis of perioperative outcomes.Updates in surgery · 2025Article
- Article
- Impact of obesity on outcomes after surgical stabilization of multiple rib fractures: Evidence from the US nationwide inpatient sample.PloS one · 2024Article
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Authors and funding
79 authors at 20 institutions in 18 countries.
Giammauro BerardiDepartment of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY; Division of General Surgery and Liver Transplantation, San Camillo Forlanini Hospital, Rome, Italy.
T Peter KinghamDepartment of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY.
Wanguang ZhangHepatic Surgery Center and Hubei Key Laboratory of Hepato-Biliary-Pancreatic Diseases, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
Nicholas L SynYong Loo Lin School of Medicine, National University of Singapore, Singapore; Department of Hepatopancreatobiliary and Transplant Surgery, Singapore General Hospital and National Cancer Centre Singapore, Singapore.
Ye-Xin KohDepartment of Hepatopancreatobiliary and Transplant Surgery, Singapore General Hospital and National Cancer Centre Singapore, Singapore.
Bashar JaberDepartment of Surgery, Fondazione Poliambulanza, Brescia, Italy.
Davit L AghayanThe Intervention Centre and Department of HPB Surgery, Oslo University Hospital, Institute of Clinical Medicine, University of Oslo, Oslo, Norway.
Tiing Foong SiowDivision of General Surgery, Department of Surgery, Far Eastern Memorial Hospital, New Taipei City, Taiwan.
Chetana LimDepartment of Digestive, HBP and Liver Transplantation, Hopital Pitie-Salpetriere, Sorbonne Universite, Paris, France.
Olivier ScattonDepartment of Digestive, HBP and Liver Transplantation, Hopital Pitie-Salpetriere, Sorbonne Universite, Paris, France.
Paulo HermanLiver Surgery Unit, Department of Gastroenterology, University of Sao Paulo School of Medicine, Sao Paulo, Brazil.
Fabricio Ferreira CoelhoLiver Surgery Unit, Department of Gastroenterology, University of Sao Paulo School of Medicine, Sao Paulo, Brazil.
Marco V MarinoGeneral Surgery Department, Azienda Ospedaliera Ospedali Riuniti Villa Sofia-Cervello, Palermo, Italy and Oncologic Surgery Department, P. Giaccone University Hospital, Palermo, Italy.
Vincenzo MazzaferroHPB Surgery and Liver Transplantation, Fondazione IRCCS Istituto Nazionale Tumori di Milano and University of Milan, Milan, Italy.
Adrian K H ChiowHepatopancreatobiliary Unit, Department of Surgery, Changi General Hospital, Singapore.
Iswanto SucandyDigestive Health Institute, AdventHealth, Tampa, FL.
Arpad IvaneczDepartment of Abdominal and General Surgery, University Medical Center Maribor, Maribor, Slovenia.
Sung Hoon ChoiDepartment of General Surgery, CHA Bundang Medical Center, CHA University School of Medicine, Seongnam, Korea.
Jae Hoon LeeDepartment of Surgery, Division of Hepato-Biliary and Pancreatic Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
Mikel GastacaHepatobiliary Surgery and Liver Transplantation Unit, Biocruces Bizkaia Health Research Institute, Cruces University Hospital, University of the Basque Country, Bilbao, Spain.
Marco VivarelliHPB Surgery and Transplantation Unit, United Hospital of Ancona, Department of Experimental and Clinical Medicine Polytechnic University of Marche, Ancona, Italy.
Felice GiulianteHepatobiliary Surgery Unit, Fondazione Policlinico Universitario A. Gemelli, IRCCS, Catholic University of the Sacred Heart, Rome, Italy.
Bernardo Dalla ValleGeneral and Hepatobiliary Surgery, Department of Surgery, Dentistry, Gynecology, and Pediatrics University of Verona, GB Rossi Hospital, Verona, Italy.
Andrea RuzzenenteGeneral and Hepatobiliary Surgery, Department of Surgery, Dentistry, Gynecology, and Pediatrics University of Verona, GB Rossi Hospital, Verona, Italy.
Chee-Chien YongDepartment of Surgery, Chang Gung Memorial Hospital, Kaohsiung, Taiwan.
Zewei ChenDepartment of Hepatobiliary Surgery, Affiliated Jinhua Hospital, Zhejiang University School of Medicine, Jinhua, China.
Mengqiu YinDepartment of Hepatobiliary Surgery, Affiliated Jinhua Hospital, Zhejiang University School of Medicine, Jinhua, China.
Constantino FondevilaGeneral and Digestive Surgery, Hospital Clinic, IDIBAPS, CIBERehd, University of Barcelona, Barcelona, Spain and General and Digestive Surgery, Hospital Universitario La Paz, IdiPAZ, CIBERehd, Madrid, Spain.
Mikhail EfanovDepartment of Hepato-Pancreato-Biliary Surgery, Moscow Clinical Scientific Center, Moscow, Russia.
Zenichi MoriseDepartment of Surgery, Okazaki Medical Center, Fujita Health University School of Medicine, Japan.
Fabrizio Di BenedettoHPB Surgery and Liver Transplant Unit, University of Modena and Reggio Emilia, Modena, Italy.
Raffaele BrustiaDepartment of Digestive and Hepatobiliary and Pancreatic Surgery, AP-HP, Henri-Mondor Hospital, Creteil, France.
Raffaele Dalla ValleHepatobiliary Surgery Unit, Department of Medicine and Surgery, University of Parma, Parma, Italy.
Ugo BoggiDivision of General and Transplant Surgery, University of Pisa, Pisa, Italy.
David GellerDepartment of Surgery, Division of Hepatobiliary and Pancreatic Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA.
Andrea BelliDepartment of Abdominal Oncology, Division of Hepatopancreatobiliary Surgical Oncology, National Cancer Center-IRCCS-G. Pascale, Naples, Italy.
Riccardo MemeoUnit of Hepato-Pancreatc-Biliary Surgery, "F. Miulli" General Regional Hospital, Acquaviva delle Fonti, Bari, Italy.
Salvatore GruttadauriaDepartment for the Treatment and Study of Abdominal Diseases and Abdominal Transplantation, Istituto di Ricovero e Cura a Carattere Scientifico-Istituto Mediterraneo per i Trapianti e Terapie ad Alta Specializzazione (IRCCS-ISMETT), University of Pittsburgh Medical Center Italy, Palermo, Italy and Department of General Surgery and Medical Surgical Specialties, University of Catania, Catania, Italy.
Alejandro MejiaThe Liver Institute, Methodist Dallas Medical Center, Dallas, TX.
James O ParkDepartment of Surgery, University of Washington Medical Center. Seattle, WA.
Fernando RotellarHPB and Liver Transplant Unit, Department of General Surgery, Clinica Universidad de Navarra, Universidad de Navarra, Pamplona, Spain and Institute of Health Research of Navarra (IdisNA), Pamplona, Spain.
Gi-Hong ChoiDivision of Hepatopancreatobiliary Surgery, Department of Surgery, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.
Ricardo Robles-CamposDepartment of General, Visceral, and Transplantation Surgery, Clinic and University Hospital Virgen de la Arrixaca, IMIB-ARRIXACA, El Palmar, Murcia, Spain.
Xiaoying WangDepartment of Liver Surgery and Transplantation, Liver Cancer Institute, Zhongshan Hospital, Fudan University, Shanghai, China.
Robert P SutcliffeDepartment of Hepatopancreatobiliary and Liver Transplant Surgery, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK.
Moritz SchmelzleDepartment of Surgery, Campus Charité Mitte and Campus Virchow-Klinikum, Charité-Universitätsmedizin, Corporate Member of Freie Universität Berlin, and Berlin Institute of Health, Berlin, Germany.
Johann PratschkeDepartment of Surgery, Campus Charité Mitte and Campus Virchow-Klinikum, Charité-Universitätsmedizin, Corporate Member of Freie Universität Berlin, and Berlin Institute of Health, Berlin, Germany.
Eric C H LaiDepartment of Surgery, Pamela Youde Nethersole Eastern Hospital, Hong Kong SAR, China.
Charing C N ChongDepartment of Surgery, Prince of Wales Hospital, The Chinese University of Hong Kong, New Territories, Hong Kong SAR, China.
Juul MeursDepartment of Digestive and Hepatobiliary/Pancreatic Surgery, Groeninge Hospital, Kortrijk, Belgium.
Mathieu D'HondtDepartment of Digestive and Hepatobiliary/Pancreatic Surgery, Groeninge Hospital, Kortrijk, Belgium.
Kazuteru MondenDepartment of Surgery, Fukuyama City Hospital, Hiroshima, Japan.
Santiago Lopez-BenHepatobiliary and Pancreatic Surgery Unit, Department of Surgery, Dr Josep Trueta Hospital, IdIBGi, Girona, Spain.
Qu LiuFaculty of Hepatopancreatobiliary Surgery, First Medical Center of Chinese People's Liberation Army (PLA) General Hospital, Beijing, China.
Rong LiuFaculty of Hepatopancreatobiliary Surgery, First Medical Center of Chinese People's Liberation Army (PLA) General Hospital, Beijing, China.
Alessandro FerreroDepartment of General and Oncological Surgery, Mauriziano Hospital, Turin, Italy.
Giuseppe Maria EttorreDivision of General Surgery and Liver Transplantation, San Camillo Forlanini Hospital, Rome, Italy.
Federica CiprianiHepatobiliary Surgery Division, IRCCS San Raffaele Hospital, Milan, Italy.
Franco PascualDepartment of Hepatobiliary Surgery, Assistance Publique Hopitaux de Paris, Centre Hepato-Biliaire, Paul-Brousse Hospital, Villejuif, France.
Daniel CherquiDepartment of Hepatobiliary Surgery, Assistance Publique Hopitaux de Paris, Centre Hepato-Biliaire, Paul-Brousse Hospital, Villejuif, France.
Junhao ZhengDepartment of General Surgery, Sir Run-Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, China.
Xiao LiangDepartment of General Surgery, Sir Run-Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, China.
Olivier SoubraneDepartment of Digestive, Oncologic, and Metabolic Surgery, Institute Mutualiste Montsouris, Universite Paris Descartes, Paris, France.
Go WakabayashiCenter for Advanced Treatment of Hepatobiliary and Pancreatic Diseases, Ageo Central General Hospital, Saitama, Japan.
Roberto I TroisiDepartment of Clinical Medicine and Surgery, Division of HPB, Minimally Invasive and Robotic Surgery, Federico II University Hospital, Naples, Italy.
Tan-To CheungDepartment of Surgery, Queen Mary Hospital, The University of Hong Kong, Hong Kong SAR, China.
Yutaro KatoDepartment of Surgery, Fujita Health University School of Medicine, Aichi, Japan.
Atsushi SugiokaDepartment of Surgery, Fujita Health University School of Medicine, Aichi, Japan.
Mizelle D'SilvaDepartment of Surgery, Seoul National University Hospital Bundang, Seoul National University College of Medicine, Seoul, Korea.
Ho-Seong HanDepartment of Surgery, Seoul National University Hospital Bundang, Seoul National University College of Medicine, Seoul, Korea.
Phan Phuoc NghiaDepartment of Hepatopancreatobiliary Surgery, University Medical Center, University of Medicine and Pharmacy, Ho Chi Minh City, Vietnam.
Tran Cong Duy LongDepartment of Hepatopancreatobiliary Surgery, University Medical Center, University of Medicine and Pharmacy, Ho Chi Minh City, Vietnam.
Bjørn EdwinThe Intervention Centre and Department of HPB Surgery, Oslo University Hospital, Institute of Clinical Medicine, University of Oslo, Oslo, Norway.
David FuksDepartment of Digestive, Oncologic, and Metabolic Surgery, Institute Mutualiste Montsouris, Universite Paris Descartes, Paris, France.
Mohammad Abu HilalDepartment of Surgery, Fondazione Poliambulanza, Brescia, Italy; Department of Surgery, University Hospital Southampton, Southampton, UK.
Luca AldrighettiHepatobiliary Surgery Division, IRCCS San Raffaele Hospital, Milan, Italy.
Kuo-Hsin ChenDivision of General Surgery, Department of Surgery, Far Eastern Memorial Hospital, New Taipei City, Taiwan.
Brian K P GohDepartment of Hepatopancreatobiliary and Transplant Surgery, Singapore General Hospital and National Cancer Centre Singapore, Singapore; Surgery Academic Clinical Programme, Duke-National University of Singapore Medical School, Singapore. Electronic address: bsgkp@hotmail.com.
International robotic and laparoscopic liver resection study group investigators
Fujita Health University · JPUlsan College · KRAssistance Publique – Hôpitaux de Paris · FRFederico II University Hospital · ITUniversity of Medicine and Pharmacy at Ho Chi Minh City · VNA. O. Ordine Mauriziano di Torino · ITAZ Groeninge · BEBerlin Institute of Health at Charité - Universitätsmedizin Berlin · DECarlo Forlanini Hospital · ITChinese People's Liberation Army · CNFar Eastern Memorial Hospital · TWFudan University · CNMarche Polytechnic University · ITMemorial Sloan Kettering Cancer Center · USNational University of Singapore · SGOslo University Hospital · NOPamela Youde Nethersole Eastern Hospital · CNSeoul National University Hospital · KRSir Run Run Shaw Hospital · CNSorbonne Université · FR
Funding
X-RAY CRYSTALLOGRAPHYP30CA008748 · NCI · SLOAN-KETTERING INSTITUTE FOR CANCER RES · PI Hongbiao Carl Lekaye · 1985 to 2026
$347.4MNCI NIH HHS P30 CA008748
Abstract
backgroundData on the effect of body mass index on laparoscopic liver resections are conflicting. We performed this study to investigate the association between body mass index and postoperative outcomes after laparoscopic major hepatectomies.
methodsThis is a retrospective review of 4,348 laparoscopic major hepatectomies at 58 centers between 2005 and 2021, of which 3,383 met the study inclusion criteria. Concomitant major operations, vascular resections, and previous liver resections were excluded. Associations between body mass index and perioperative outcomes were analyzed using restricted cubic splines. Modeled effect sizes were visually rendered and summarized.
resultsA total of 1,810 patients (53.5%) had normal weight, whereas 1,057 (31.2%) were overweight and 392 (11.6%) were obese. One hundred and twenty-four patients (3.6%) were underweight. Most perioperative outcomes showed a linear worsening trend with increasing body mass index. There was a statistically significant increase in open conversion rate (16.3%, 10.8%, 9.2%, and 5.6%, P < .001), longer operation time (320 vs 305 vs 300 and 266 minutes, P < .001), increasing blood loss (300 vs 300 vs 295 vs 250 mL, P = .022), and higher postoperative morbidity (33.4% vs 26.3% vs 25.0% vs 25.0%, P = .009) in obese, overweight, normal weight, and underweight patients, respectively (P < .001). However, postoperative major morbidity demonstrated a "U"-shaped association with body mass index, whereby the highest major morbidity rates were observed in underweight and obese patients.
conclusionLaparoscopic major hepatectomy was associated with poorer outcomes with increasing body mass index for most perioperative outcome measures.
Indexed as
HepatectomyLaparoscopyBody Mass IndexHumansLength of StayObesityOverweightPostoperative ComplicationsRetrospective StudiesThinnessTreatment Outcome
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