title: Laparoscopic hepatectomy in a morbidly obese patient with liver cirrhosis: A case report.
abstract: 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.
authors.affiliation: 2nd Department of Propedeutic Surgery, University of Athens Medical School, General Hospital Laiko, 11527 Athens, Greece.
authors.forename: Nikolaos
authors.initials: N
authors.lastname: Machairas
authors.affiliation: 2nd Department of Propedeutic Surgery, University of Athens Medical School, General Hospital Laiko, 11527 Athens, Greece.
authors.forename: Ioannis D
authors.initials: ID
authors.lastname: Kostakis
authors.affiliation: 2nd Department of Propedeutic Surgery, University of Athens Medical School, General Hospital Laiko, 11527 Athens, Greece.
authors.forename: Dimitrios
authors.initials: D
authors.lastname: Mantas
authors.affiliation: 2nd Department of Propedeutic Surgery, University of Athens Medical School, General Hospital Laiko, 11527 Athens, Greece.
authors.forename: Georgios C
authors.initials: GC
authors.lastname: Sotiropoulos
keywords: laparoscopy; liver cirrhosis; liver resection; minimal invasive surgery; morbid obesity