{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,5,14]],"date-time":"2025-05-14T00:43:53Z","timestamp":1747183433467,"version":"3.40.5"},"reference-count":10,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2020,10,22]],"date-time":"2020-10-22T00:00:00Z","timestamp":1603324800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Asian J Endoscop Surgery"],"published-print":{"date-parts":[[2021,7]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>The risk of complications after bariatric surgery is high in morbidly obese patients suffering from liver cirrhosis along with moderate to severe portal hypertension. Esophageal varices are even considered as a contraindication for bariatric surgery by many surgeons. We report the case of a 40\u2010year\u2010old gentleman with a body mass index of 65.3\u00a0kg\/m<jats:sup>2<\/jats:sup>, with multiple comorbidities including type 2 diabetes mellitus, severe obstructive sleep apnea. On evaluation, he had Child\u2010Pugh A liver cirrhosis with portal hypertension along with grade III esophageal varices and splenomegaly. After adequate optimization, laparoscopic sleeve gastrectomy was performed. The patient is doing well at a follow up of 12\u2009months with an adequate weight loss and resolution of comorbidities. Sleeve gastrectomy can be performed in a morbidly obese Child\u2010Pugh A cirrhotic patient with portal hypertension and esophageal varices with proper counseling regarding more than usual risk for morbidity and mortality.<\/jats:p>","DOI":"10.1111\/ases.12882","type":"journal-article","created":{"date-parts":[[2020,10,23]],"date-time":"2020-10-23T08:27:31Z","timestamp":1603441651000},"page":"570-573","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Surgical management of super\u2010super obesity with grade III esophageal varices and liver cirrhosis: The ultimate challenge"],"prefix":"10.1111","volume":"14","author":[{"given":"Amit","family":"Bhambri","sequence":"first","affiliation":[{"name":"Department of Surgical disciplines All India Institute of Medical Sciences  New Delhi India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Vitish","family":"Singla","sequence":"additional","affiliation":[{"name":"Department of Surgical disciplines All India Institute of Medical Sciences  New Delhi India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Aashir","family":"Kaul","sequence":"additional","affiliation":[{"name":"Department of Surgical disciplines All India Institute of Medical Sciences  New Delhi India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"family":"Shalimar","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology All India Institute of Medical Sciences  New Delhi India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lokesh","family":"Kashyap","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology All India Institute of Medical Sciences  New Delhi India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9540-0303","authenticated-orcid":false,"given":"Sandeep","family":"Aggarwal","sequence":"additional","affiliation":[{"name":"Department of Surgical disciplines All India Institute of Medical Sciences  New Delhi India"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2020,10,22]]},"reference":[{"key":"e_1_2_4_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2004.02.013"},{"key":"e_1_2_4_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.surg.2003.10.003"},{"key":"e_1_2_4_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cgh.2011.07.007"},{"key":"e_1_2_4_5_1","doi-asserted-by":"publisher","DOI":"10.5812\/hepatmon.8536"},{"key":"e_1_2_4_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.mayocp.2014.11.012"},{"key":"e_1_2_4_7_1","doi-asserted-by":"publisher","DOI":"10.1381\/096089204772787284"},{"key":"e_1_2_4_8_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11695-015-1727-2"},{"key":"e_1_2_4_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1665-2681(19)30934-2"},{"key":"e_1_2_4_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijsu.2015.12.007"},{"key":"e_1_2_4_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.soard.2012.07.021"}],"container-title":["Asian Journal of Endoscopic Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/ases.12882","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/ases.12882","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/ases.12882","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,8,30]],"date-time":"2023-08-30T11:00:55Z","timestamp":1693393255000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/ases.12882"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,10,22]]},"references-count":10,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2021,7]]}},"alternative-id":["10.1111\/ases.12882"],"URL":"https:\/\/doi.org\/10.1111\/ases.12882","archive":["Portico"],"relation":{},"ISSN":["1758-5902","1758-5910"],"issn-type":[{"type":"print","value":"1758-5902"},{"type":"electronic","value":"1758-5910"}],"subject":[],"published":{"date-parts":[[2020,10,22]]},"assertion":[{"value":"2020-06-27","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2020-10-11","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2020-10-22","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}