Fatty Liver Does Not Increase the Risk of Postoperative Liver Damage Following Hepatectomy

The number of patients with fatty liver due to alcohol consumption, metabolic syndrome, non-alcoholic fatty liver disease, and non-alcoholic steatohepatitis is increasing. Since there is no consensus on the risk of hepatectomy for patients with fatty liver, this study examined the clinical outcomes of hepatectomy for fatty liver patients via evaluation of transaminase.

Patients (n=164) who underwent hepatectomy for primary liver tumors from January 2014 to March 2019 were included in the study. Patients were divided into steatohepatitis (n=19), steatosis (n=20), and control (n=30) groups. Serum values of aspartate aminotransferase (AST), alanine transaminase (ALT), total bilirubin (TB), prothrombin time (PT), white blood cells, and platelets were compared before and immediately after surgery, and on postoperative days 1-5, 7, and 10. And their rates of change were compared using the preoperative value as a reference value.

Overall, AST and ALT elevation rates were higher in the control group than in the steatosis and steatohepatitis groups from postoperative days 2-7. There was no difference in postoperative hepatic dysfunction between the steatosis and steatohepatitis groups. Univariate analysis revealed significant differences in liver stiffness, operative time, mobilization, and Pringle time. Multivariate analysis indicated low liver stiffness and longer Pringle time as independent risk factors. Postoperative change in TB, PT, and albumin levels did not differ between the groups. There was no difference in postoperative complications and hospital stay between the groups.

Fatty liver does not increase the risk of postoperative liver damage following hepatectomy.