Laparoscopic Sleeve Gastrectomy on the Horizon as a Promising Treatment Modality for NAFLD

Theodor Bilharz Research Institute

Bibliographic Information

Authors: Salman M.A.; Salman A.A.; Abdelsalam A.; Atallah M.; Shaaban H.E.-D.; El-Mikkawy A.; Omar M.G.; Elshenoufy M.

Journal: Obesity Surgery

Publisher: Springer

Publication Date: 1 August 2019

Volume / Issue: Volume 30 / Issue 1

Pages: 87–95

ISSN: 9608923

DOI: 10.1007/s11695-019-04118-6

Scopus: View on Scopus

PubMed: 31372873

Document Type: Article

Authors and Affiliations

Salman M.A., General Surgery Department, Faculty of Medicine, Cairo University, Cairo, Egypt; Salman A.A., Internal Medicine Department, Faculty of Medicine, Cairo University, Cairo, 11311, Egypt; Abdelsalam A., General Surgery Department, Faculty of Medicine, Cairo University, Cairo, Egypt; Atallah M., National Hepatology and Tropical Medicine Research Institute, Cairo, Egypt; Shaaban H.E.-D., National Hepatology and Tropical Medicine Research Institute, Cairo, Egypt; El-Mikkawy A., Hepatology and Gastroenterology Department, Theodor Bilharz Research Institute, Gizah, Egypt; Omar M.G., Internal Medicine Department, Faculty of Medicine, Cairo University, Cairo, 11311, Egypt; Elshenoufy M., Internal Medicine Department, Faculty of Medicine, Cairo University, Cairo, 11311, Egypt

Abstract

Introduction: Nonalcoholic fatty liver disease (NAFLD) is viewed as the hepatic manifestation of the metabolic syndrome with hepatic fatty infiltration is the common liver pathology. NAFLD can lead to nonalcoholic steatohepatitis (NASH), liver cirrhosis, liver cell failure, and liver malignancy.The present work aims to prospectively study the histological changes that occur in NAFLD obese patients 1-year post-laparoscopic sleeve gastrectomy (LSG) based on standardized NAS (NAFLD activity score). Patients: This prospective study included 94 obese patients who underwent laparoscopic sleeve gastrectomy. Intraoperative wedge liver biopsy was taken from all patients with a follow-up liver biopsy at 12 months after the operation. Results: LSG produced a marked reduction in body weight with a mean reduction in BMI from 44.54 + 5.45 to 34.23 + 2.66 kg/m2 at 12 months. There were statistically highly significant improvements regarding metabolic comorbidities, blood pressure, lipid profile, and HbA1C at 12-month post-LSG (P < 0.001). The current study showed a highly statistically significant improvement at 1-year post LSG regarding steatosis grade, hepatocyte ballooning, lobular inflammation as well as fibrosis stage (P < 0.001). Moreover, the present study showed that NAS score significantly decreased from 5.20 + 1.96 at baseline to 2.63 + 1.55 at 1-year follow-up (P < 0.001). Conclusion: Our relatively large patient cohort shows a significant improvement of steatosis, steatohepatitis, and fibrosis at a 1-year follow-up. LSG can lead to resolution of NAFLD, and it may be in the near future another routine indication for bariatric surgery. © 2019, Springer Science+Business Media, LLC, part of Springer Nature.

Keywords

Laparoscopic sleeve gastrectomy; NAFLD; Adult; Biopsy; Cohort Studies; Female; Follow-Up Studies; Gastrectomy; Humans; Laparoscopy; Liver; Male; Middle Aged; Non-alcoholic Fatty Liver Disease; Obesity; Prognosis; Prospective Studies; Treatment Outcome; Weight Loss; Young Adult; alanine aminotransferase; aspartate aminotransferase; gamma glutamyltransferase; Article; body weight loss; follow up; histology; histopathology; human; human tissue; liver biopsy; liver fibrosis; major clinical study; nonalcoholic fatty liver; obese patient; priority journal; prospective study; cohort analysis; complication; pathology; procedures

Citation Information

Scopus Citations: 32

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