Clinical Research Directory

Inclusion Criteria: 1. Be willing and able to provide written informed consent/assent for the trial 2. Be ≥ 18 years of age on day of signing informed consent. 3. Have hepatocellular carcinoma with metabolic syndrome as unique risk factor 4. Have an overall Child-Pugh score = A 5. Be eligible for liver resection with laparoscopic or robotic technique 6. Be eligible for bariatric surgery as defined below * BMI ≥ 40 kg/m2 * BMI ≥ 35-40 kg/m2 with associated comorbidities * BMI 30-35 kg/m2 and type 2 diabetes * BMI 30-35 kg/m2 and arterial hypertension with poor control despite optimal medical therapy. Exclusion Criteria: 1. Have hepatocellular carcinoma related to other etiology, even in case of coexisting metabolic syndrome 2. Denial of the patient to undergo bariatric procedure 3. Have BMI \< 30 4. Have negative opinion of psychologic consultant 5. Have an overall Child-Pugh score \> 7 6. Evidence of clinical significant portal hypertension as followed: * esophageal varices * gastric varices * portal hypertensive gastropathy * gastric vascular ectasia Of note: 1) Conversion to open surgery for any reason does not represent a reason of data exclusion from the analysis; 2) any type of hepatic resection, according to Brisbane classification, is included, also major hepatectomy requiring preoperative intervention to achieve adequate volume remnant