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Metabolic syndrome and hepatic surgery
C Hobeika1, M Ronot2, A Beaufrere3
1Service de chirurgie hépato-bilio-pancréatique et transplantation hépatique, Hôpital Beaujon, AP-HP et Université de Paris, 100, boulevard du Général Leclerc, 92110, Clichy, France.
Journal of Visceral Surgery
|December 24, 2019
Summary
Metabolic syndrome (MS) and non-alcoholic fatty liver disease (NAFLD) increase risks for liver cancer surgery and transplantation. Optimized management is crucial for these high-risk patients.
Area of Science:
- Hepatology
- Oncology
- Metabolic Diseases
Background:
- Metabolic syndrome (MS) affects 25% of Europeans, with non-alcoholic fatty liver disease (NAFLD) as its hepatic manifestation.
- NAFLD, characterized by hepatic steatosis, is linked to hepatocellular carcinoma (HCC) and intrahepatic cholangiocarcinoma (ICC) development.
- MS and NAFLD significantly increase risks for liver cancer surgery and transplantation.
Purpose of the Study:
- To highlight the increased operative risks in patients with MS and NAFLD undergoing liver resection or transplantation for HCC and ICC.
- To emphasize the need for tailored management strategies for these complex patients.
Main Methods:
- Review of current literature on MS, NAFLD, HCC, and ICC.
- Analysis of surgical and transplantation outcomes in patients with MS and NAFLD.
- Discussion of management strategies for optimizing operative risk.
Main Results:
- MS and NAFLD are implicated in 15-30% of HCC and ICC cases requiring hepatic resection.
- NAFLD is becoming a leading indication for liver transplantation in industrialized nations.
- Patients with MS and NAFLD face heightened morbidity (20-30%) and mortality due to cardiovascular and infectious complications.
Conclusions:
- Precise liver characterization, cardiovascular risk factor management, and adapted surgical strategies are essential for MS patients.
- Optimizing the management of MS and NAFLD is critical to improve outcomes for liver cancer surgery and transplantation.
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