Doença hepática não-alcoólica: evolução após derivação gastrojejunal em Y-de-Roux pela técnica de fobi-capella

Freitas, Alexandre Coutinho Teixeira de; Freitas, Diane Teixeira de; Parolin, Mônica Beatriz; Campos, Antônio Carlos Ligocki; Coelho, Júlio Cézar Uili

doi:10.1590/s0004-28032007000100011

Cited by 11 publications

(5 citation statements)

References 41 publications

(68 reference statements)

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“…Among the 40 patients, nine had preoperative advanced liver fibrosis; of these, eight (88.9%) were from the public network, responsible for a higher mean BMI than the private one. This is in agreement with the literature, because according to the National Health and Nutrition Examination Survey III, the prevalence of primary non-alcoholic liver disease increases according to the BMI 9 .…”

Section: Discussionsupporting

confidence: 93%

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Comparison of Hepatic Profile in Pre and Postoperative of Bariatric Surgery: Private vs Public Network

Nascimento

Alves-Júnior

Nunes

et al. 2015

ABCD, arq. bras. cir. dig.

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Background: Obesity is associated to several comorbidities, including nonalcoholic fatty liver disease, which implicates in isolated steatosis to steatohepatitis. The latter may progress to severe manifestations such as liver fibrosis, cirrhosis and hepatocellular carcinoma. Aim: To compare the presence of advanced liver fibrosis before and after bariatric surgery in patients of private and public health system. Methods: Patients from public and privative networks were studied before and after bariatric surgery. The presence or absence of advanced hepatic fibrosis was evaluated by NAFLD Fibrosis Score, a non-invasive method that uses age, BMI, AST/ALT ratio, albumin, platelet count and the presence or absence of hyperglycemia or diabetes. The characteristics of the two groups were compared. The established statistical significance criterion was p<0.05. Results: Were analyzed 40 patients with a mean age of 34.6±9.5 years for private network and 40.6± 10.2 years for public. The study sample, 35% were treated at private health system and 65% in the public ones, 38% male and 62% female. Preoperatively in the private network one (7.1%) patient had advanced liver fibrosis and developed to the absence of liver fibrosis after surgery. In the public eight (30.8%) patients had advanced liver fibrosis preoperatively, and at one year after the proportion fell to six (23%). Conclusion: The non-alcoholic fatty liver disease in its advanced form is more prevalent in obese patients treated in the public network than in the treated at the private network and bariatric surgery may be important therapeutic option in both populations.

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Section: Discussionsupporting

confidence: 93%

“…Other studies determine the prevalence of non-alcoholic liver disease in patients referred for bariatric surgery. Marceau et al demonstrated prevalence of 86% to steatosis, 23% to steatohepatitis and 2% to cirrhosis among 551 patients 9 .…”

Section: Discussionmentioning

confidence: 99%

Comparison of Hepatic Profile in Pre and Postoperative of Bariatric Surgery: Private vs Public Network

Nascimento

Alves-Júnior

Nunes

et al. 2015

ABCD, arq. bras. cir. dig.

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“…There is a transient elevation of liver enzymes, which tend to remain high for a period of two to six months after surgery. A significant decrease followed this increase in the period from 10 to 12 months after surgery, maintenance of low levels up to 10 years of surgery 13 , 14 . Thus, our research indicated compliance with the literature data.…”

Section: Discussionsupporting

confidence: 89%

“…Moreover, studies have shown reduced hepatic steatosis following bariatric surgery. The possible mechanisms responsible for reducing the incidence of non-alcoholic fatty liver disease in these patients correspond to improved peripheral insulin sensitivity and reduced inflammatory markers 7 , 13 , 14 . Although biochemical concentrations of liver enzymes and their alterations are not considered gold standard for diagnosis and evaluation of hepatic steatosis, many studies use AST and ALT transaminases to evaluate the effect of bariatric surgery on hepatic metabolism.…”

Section: Discussionmentioning

confidence: 99%

Is There Any Change in Phenotypic Characteristics Comparing 5 to 10 Years of Follow-Up in Obese Patients Undergoing Roux-en-Y Gastric Bypass?

Nonino

Oliveira

Chaves

et al. 2019

ABCD, arq. bras. cir. dig.

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Background : Bariatric surgery promotes significant weight loss and improvement of associated comorbidities; however, nutrients deficiencies and weight regain may occur in the middle-late postoperative period. Aim: To investigate nutritional status in 10 years follow-up. Methods : Longitudinal retrospective study in which anthropometric, biochemical indicators and nutritional intake were assessed before and after one, two, three, four, five and ten years of Roux-en Y gastric bypass through analysis of medical records. Results : After ten years there was a reduction of 29.2% of initial weight; however, 87.1% of patients had significant weight regain. Moreover, there was an increase of incidence of iron (9.2% to 18.5%), vitamin B12 (4.2% to 11.1%) and magnesium deficiency (14.1% to 14.8%). Folic acid concentrations increased and the percentage of individuals with glucose (40.4% to 3.7%), triglycerides (38% to 7.4%), HDL cholesterol (31 % to 7.4%) and uric acid (70.5% to 11.1%) abnormalities reduced. Also, there is a reduction of food intake at first year postoperative. After 10 years, there was an increase in energy, protein and lipid intake, also a reduction in folid acid intake. Conclusions : Roux-en Y gastric bypass is an effective procedure to promote weight loss and improve comorbidities associated with obesity. However, comparison between postoperative period of five and 10 years showed a high prevalence of minerals deficiency and a significant weight regain, evidencing the need for nutritional follow-up in the postoperative period.

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“…A obesidade é considerada o fator de risco mais importante no desenvolvimento de doença hepática não-alcoólica (DHGNA) (Freitas, Freitas, Parolin, Campos, & Coelho, 2007). Segundo Freitas et al (2007), diversos estudos demonstram a prevalência de EH em pacientes com indicação de cirurgia bariátrica, assim como uma pesquisa que apontou prevalência de tal comorbidade em pacientes com obesidade de 76% (Bellentani et al, 2000) e outro estudo que demonstrou prevalência de 86% para esteatose em 551 pacientes obesos (Marceau et al, 1999). No presente estudo 66,7% pacientes submetidos à cirurgia bariátrica apresentavam EH no pré-operatório, sendo 39,3% deles grau III (esteatose grave), 39,3% de grau II (esteatose moderada) e 21,4% de grau I (esteatose leve).…”

Section: Discussionunclassified

Análise do controle da esteatose hepática em pacientes após cirurgia bariátrica

Cardoso

Fornari

Menezes

et al. 2021

RSD

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Objetivo: Avaliar a associação entre o controle de esteatose hepática (EH) e o pós-operatório de cirurgia bariátrica em uma instituição privada de Sergipe. Metodologia: Estudo retrospectivo observacional, unicêntrico, com dados coletados por meio de formulário online, previamente autorizado, por 57 pacientes sem distinção de sexo, com obesidade grau III ou grau II associada a comorbidades, submetidos à cirurgia bariátrica pelas técnicas de Gastrectomia Vertical (Sleeve Gástrico) ou Gastroplastia Redutora em Y-de-Roux (Bypass Gástrico) por videolaparoscopia, em uma instituição privada de Aracaju/SE, entre 2019 e 2021. Após aplicados os critérios de exclusão, foram analisados 45 pacientes. Dados analisados por meio de frequência percentual, testes de Pearson e de McNemar. Nível de significância adotado de 5%. Resultado: No pré-operatório foi encontrada prevalência de EH em 66,7% desses e no pós-operatório a prevalência encontrada foi de 16,7%, com redução do grau da patologia ao exame ultrassonográfico para EH grau I. A cirurgia bariátrica foi curativa em 83,3% dos pacientes com EH no pré-operatório, possuindo melhora clínica em 23 (67,6%) daqueles submetidos ao Sleeve Gástrico e 7 (63,6%), ao Bypass Gástrico. Conclusão: Percebeu-se associação significativa entre cirurgia bariátrica e a resolução da esteatose hepática, independente da técnica cirúrgica utilizada.

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Doença hepática não-alcoólica: evolução após derivação gastrojejunal em Y-de-Roux pela técnica de fobi-capella

Cited by 11 publications

References 41 publications

Comparison of Hepatic Profile in Pre and Postoperative of Bariatric Surgery: Private vs Public Network

Comparison of Hepatic Profile in Pre and Postoperative of Bariatric Surgery: Private vs Public Network

Is There Any Change in Phenotypic Characteristics Comparing 5 to 10 Years of Follow-Up in Obese Patients Undergoing Roux-en-Y Gastric Bypass?

Análise do controle da esteatose hepática em pacientes após cirurgia bariátrica

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