Intraoperative Liver Biopsy During Adolescent Bariatric Surgery: Is It Really Necessary?
ConclusionsRoutine intraoperative liver biopsy during adolescent bariatric surgery possesses questionable benefit, as it does not appear to impact short-term postoperative management. Prospective, longitudinal studies are needed to better understand the meaningfulness of liver histopathology in this population.
Nonalcoholic Fatty Liver Disease (NAFLD) prevalence is rising worldwide, as a direct consequence of the obesity epidemic. Bariatric Surgery provides proven NAFLD amelioration, although questions remain if Roux-en-Y Gastric Bypass (RYGB) or Laparoscopic Sleeve Gastrectomy (LSG) is more effective. To answer this question, we conducted a Systematic review and meta-analysis exclusively comparing RYGB against LSG for amelioration of NAFLD using four separate criteria: ALT, AST, NAFLD activity score (NAS), and NAFLD fibrosis score (NFS).
ConclusionAmong individuals with morbid obesity, the findings of this study are suggestive that liver fibrosis confirmed by histopathological examination is associated with a slight impairment of left ventricular function. Further studies are needed to confirm this association.
Bariatric surgery is still not recommended to alleviate the long-term sequelae of non-alcoholic fatty liver disease (NAFLD) despite some evidence to suggest bariatric surgery can mitigate the risk of non-alcoholic steatohepatitis (NASH) and/or hepatocellular carcinoma. This current study is the first to use a propensity match analysis of a large cohort of bariatric surgery patients with non-surgery controls to show that patients who had undergone bariatric surgery had fewer new cases of NASH and HCC with extended follow up, and further risk adjustment also revealed bariatric surgery was associated with fewer cases of NASH ...
ConclusionsIntraoperative liver biopsy during bariatric surgery is safe and identified liver disease in 89%, with 9% meeting referral criteria. Pasifika patients have a higher rate of NAFLD than non-Pasifika.
A low-calorie diet (LCD) before bariatric surgery has been shown to reduce liver volume and facilitate ease of operation. It is estimated that 75% –100% of individuals undergoing bariatric surgery have nonalcoholic fatty liver disease (NAFLD).
A low calorie diet (LCD) prior to bariatric surgery has been shown to reduce liver volume and facilitate ease of operation. It is estimated that 75 -100% of individuals undergoing bariatric surgery have non-alcoholic fatty liver disease (NAFLD).
CONCLUSION: We conclude that in non-diabetic, severely obese humans, excess intrahepatic lipid is associated with limited export of triglyceride in VLDL particles rather than increased uptake of systemic free fatty acids. PMID: 31408176 [PubMed - as supplied by publisher]
Publication date: Available online 10 August 2019Source: Nutrition, Metabolism and Cardiovascular DiseasesAuthor(s): Federica Coccia, Moira Testa, Gloria Guarisco, Claudio Di Cristofano, Gianfranco Silecchia, Frida Leonetti, Amalia Gastaldelli, Danila CapocciaAbstractBackgroundObese subjects are at high risk of nonalcoholic fatty liver disease (NAFLD) and diabetes (T2D) due to insulin resistance (IR). Since high glucose levels are as toxic as lipids for hepatic metabolism, we hypothesize that altered response to oral glucose tolerance test (OGTT) is associated to more severe NAFLD with significant/advanced liver damage.Met...
We read with interest the recent paper by Styczy ński and coworkers . Their findings revealed no significant association between non-alcoholic fatty liver disease (NAFLD) on wedge liver biopsy and an increased arterial stiffness – as reflected by aortic pulse wave velocity (PWV) – in a sample of 120 morbidly obese patients. The authors are to be congratulated for specifically examining this issue in a high-risk clinical population of patients who were consecutively admitted for bariatric surgery.
ConclusionNAFLD patients had lower mortality and complication rates following BS. A significant postsurgical weight loss should attenuate liver inflammation and fibrosis, and therefore has the potential to stop or even reverse progression of liver disease.