title: Major liver resection for hepatocellular carcinoma in the morbidly obese: a proposed strategy to improve outcome.
abstract: BACKGROUND
  Morbid obesity strongly predicts morbidity and mortality in surgical patients. However, obesity's impact on outcome after major liver resection is unknown.
  
  
  METHODS
  We describe the management of a large hepatocellular carcinoma in a morbidly obese patient (body mass index >50 kg/m2). Additionally, we propose a strategy for reducing postoperative complications and improving outcome after major liver resection.
  
  
  CONCLUSIONS
  To our knowledge, this is the first report of major liver resection in a morbidly obese patient with hepatocellular carcinoma. The approach we used could make this operation nearly as safe in obese patients as it is in their normal-weight counterparts.
authors.affiliation: Department of Surgery, Texas Heart Institute at St, Luke's Episcopal Hospital, Houston, Texas, USA. omarbarakat@sbcglobal.net
authors.forename: Omar
authors.initials: O
authors.lastname: Barakat
authors.forename: Mark D
authors.initials: MD
authors.lastname: Skolkin
authors.forename: Barry D
authors.initials: BD
authors.lastname: Toombs
authors.forename: John H
authors.initials: JH
authors.lastname: Fischer
authors.forename: Claire F
authors.initials: CF
authors.lastname: Ozaki
authors.forename: R Patrick
authors.initials: RP
authors.lastname: Wood
mesh_terms: D000328:Adult; D006528:Carcinoma, Hepatocellular / Q000150:complications / Q000601:surgery*; D005260:Female; D006498:Hepatectomy / Q000009:adverse effects; D006801:Humans; D008113:Liver Neoplasms / Q000150:complications / Q000601:surgery*; D009767:Obesity, Morbid / Q000150:complications*; D011183:Postoperative Complications / Q000209:etiology / Q000517:prevention & control; D016896:Treatment Outcome
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