Efficacy and Safety of Bariatric Surgery in Well-Compensated Liver Cirrhosis: A Systematic Review and a Single-Arm Meta-analysis
- 03.09.2025
- Research
Erschienen in:
- Verfasst von
- Pandora Fonseca
- Leonardo Pereira
- João Gabriel Braga
- Giovanna Macanhã Scremin
- Luísa de Araujo
- Julia Alves
- Gabriel de França
- Pedro Bregion
- Rafael Rego
- Maria Farias
- Victor Ivano
- Erschienen in
- Obesity Surgery | Ausgabe 10/2025
Abstract
Introduction
The global rise in obesity and liver disease underscores the significance of bariatric and metabolic surgery (BMS) in treating severe obesity and improving liver function. Although liver failure is often considered a contraindication for elective surgeries, the role of bariatric surgery in patients with compensated cirrhosis has been increasingly explored.
Methods
We systematically searched PubMed, Embase, and Cochrane without temporal restrictions, in January 2025 for randomized controlled trials and observational studies. Statistical analyses were performed using R software. Heterogeneity was assessed with I2 statistics.
Results
This meta-analysis evaluated BMS's efficacy and safety in patients with cirrhosis by analyzing 26 studies with 22,489 participants. Mortality was 3.33% (95% CI [2.06; 5.35]; I2 = 96.7%). Early postoperative complications were 14.0% (95% CI [7.56; 24.49]; I2 = 90.3%). Patients with cirrhosis had a significant weight loss after 1 year of follow-up (MD -43.06 kg; 95% CI [-70.93; -15.19]; P < 0.0001; I2 = 94.0%), BMI (MD -10.79 kg/m2; 95% CI [-14.45,-7.12]; P < 0.01; I2 = 66.2%), excess weight loss in percentage—EWL% 62.81% (95% CI [52.56; 73.96]; I2 = 78%) and total weight loss in percentage TWL% (26.43% 95% CI [23.89; 28.96]; I2 = 69.3%). The length of stay was 3.77 days ( 95% CI [3.13; 4.42]; I2 = 99.1%).
Conclusion
Despite increased perioperative risks, mortality remained low, and patients with compensated cirrhosis achieved substantial weight and metabolic improvements, supporting BMS's safety and benefits with proper patient selection.
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- Titel
- Efficacy and Safety of Bariatric Surgery in Well-Compensated Liver Cirrhosis: A Systematic Review and a Single-Arm Meta-analysis
- Verfasst von
-
Pandora Fonseca
Leonardo Pereira
João Gabriel Braga
Giovanna Macanhã Scremin
Luísa de Araujo
Julia Alves
Gabriel de França
Pedro Bregion
Rafael Rego
Maria Farias
Victor Ivano
- Publikationsdatum
- 03.09.2025
- Verlag
- Springer US
- Erschienen in
-
Obesity Surgery / Ausgabe 10/2025
Print ISSN: 0960-8923
Elektronische ISSN: 1708-0428 - DOI
- https://doi.org/10.1007/s11695-025-08189-6
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