Two-staged surgery for metastatic liver tumor in morbidly obese individual-left hemihepatectomy following placement of laparoscopic adjustable gastric band.

A 47-year-old male with a body mass index (BMI) 37.12 kg/m(2) was diagnosed with an ill-demarcated tumor within IVB segment of left lobe of the liver. Sixteen months earlier, he underwent laparoscopic gastric banding for morbid obesity (BMI 51 kg/m(2)). One year after bariatric procedure, he was diagnosed with rectal adenocarcinoma. Following abdominoperineal resection of rectum with total mesorectal excision and 2 months course of adjuvant FOLFOX chemotherapy, he was scheduled for liver resection. Left hemihepatectomy was performed with no major complications; wound discharge was successfully treated in outpatient clinic. Twelve months following surgery, he remains disease free with no evidence of local recurrence, metachronic primary tumor, or distant metastases. This is first to our knowledge report providing data on the outcome of left hemihepatectomy performed in postbariatric patient. The role of bariatric surgery and utilization of the time necessary for neoadjuvant chemotherapy to reduce the excessive body mass and the degree of liver steatosis is discussed.