Simultaneous right hepatectomy and gastric plication: a case report

Severe obesity is associated with increased perioperative risk after major hepatectomy and may adversely affect long-term outcomes. Whilst bariatric surgery is an effective treatment for obesity, simultaneous liver resection and bariatric procedures are rarely performed outside the transplant setting. We report a case of a 29-year-old woman (body mass index 39.3 kg/m²) with hepatocellular adenoma who underwent a one-stage right hepatectomy followed by gastric plication. Operative time was 199 min with blood loss of 500 ml and no transfusion required. The postoperative course was uneventful, with no complications ≥ Clavien-Dindo grade II. The patient was discharged on postoperative day 9. Histology confirmed R0 resection. At 3 months, the patient achieved a 15-kg weight loss with improved metabolic parameters. This case demonstrates that simultaneous major hepatectomy combined with restrictive bariatric surgery is feasible and safe in carefully selected patients.