Outcomes of Bariatric Surgery in Patients with Liver Cirrhosis: a Systematic Review

Ahmed, Saleem; Pouwels, Sjaak; Parmar, Chetan; Kassir, Radwan; Luca, Maurizio De; Graham, Yitka; Mahawar, Kamal

doi:10.1007/s11695-021-05289-x

Cited by 33 publications

(18 citation statements)

References 39 publications

(39 reference statements)

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“…Furthermore, short‐ and long‐term morbidity and mortality in patients with cirrhosis undergoing bariatric surgery seems to be higher as compared with patients without this condition. 32 VLCDs can yield substantial weight loss amongst most patients. However, the potential benefits of VLCD for patients with NAFLD and NASH before progression to cirrhosis, and in patients with ESLD are insufficiently studied.…”

Section: Discussionmentioning

confidence: 99%

The use of very low‐calorie diets in subjects with obesity complicated with nonalcoholic fatty liver disease: A scoping review

Herrington

Peterson

Cheng

et al. 2022

Obesity Science & Practice

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This scoping review synthesizes the existing research on the use of very low‐calorie diets (VLCDs) in subjects with nonalcoholic fatty liver disease (NAFLD) and end‐stage liver disease (ESLD). 19 studies were included, of which 5 were clinical trials, 11 were cohort studies, 1 was a case‐control study, and 2 were case series totaling 968 subjects. About 17 studies were focused on patients with NAFLD while the two case series described in patients with ESLD on the transplant list or post‐liver transplant. Six studies included subjects managed with VLCDs prior bariatric surgery. Most studies were short term and demonstrated acute improvement of diverse liver biomarkers including liver function tests, indices of hepatosteatosis and reduction in liver size. Adherence rates in these studies were between 69% and 93%. Eight studies did not report any adverse events and four subjects were reported to have discontinued VLCD due to adverse effects in two different studies. Aggregated adverse events were mild. Treatments based on VLCD in subjects with NAFLD seem to be safe and tolerable but can result in mild adverse effects. The findings of this scoping review suggest that the use of VLCD in patients with obesity complicated with NAFLD and potentially in ESLD appear to be effective to induce weight loss and to acutely reduce hepatosteatosis.

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Section: Discussionmentioning

confidence: 99%

The use of very low‐calorie diets in subjects with obesity complicated with nonalcoholic fatty liver disease: A scoping review

Herrington

Peterson

Cheng

et al. 2022

Obesity Science & Practice

View full text Add to dashboard Cite

show abstract

“…It has to be said that a small proportion of the patients undergoing bariatric and metabolic surgery develop NASH or suffer from aggravation of the disease (NAFLD/NASH/ live fibrosis) after bariatric surgery [ 81 ]. Also the patients on the ‘end of the spectrum’, with liver cirrhosis are in need of special preparation before and after bariatric and metabolic surgery, as highlighted in the systematic reviews done by Jan et al [ 82 ] and Ahmed et al [ 83 ] We need to consider that different surgical procedures have different effects on postoperative physiological remodelling and also can lead to (liver-related) complications. (See Fig.…”

Section: Introductionmentioning

confidence: 99%

“…1 Complications in patients with liver cirrhosis undergoing bariatric and metabolic surgery. * Studies used in both the reviews by Jan et al [ 82 ] en Ahmed et al [ 83 ] (References [ 84 – 104 ]). A Showing all complications of all bariatric surgical procedures [ 84 – 104 ].…”

Section: Introductionmentioning

confidence: 99%

Non-alcoholic fatty liver disease (NAFLD): a review of pathophysiology, clinical management and effects of weight loss

et al. 2022

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Given the increasing prevalence of diabetes and obesity worldwide, the deleterious effects of non-alcoholic fatty liver disease (NAFLD) are becoming a growing challenge for public health. NAFLD is the most common chronic liver disease in the Western world. NAFLD is closely associated with metabolic disorders, including central obesity, dyslipidaemia, hypertension, hyperglycaemia and persistent abnormalities of liver function tests.In general NAFLD is a common denominer for a broad spectrum of damage to the liver, which can be due to hepatocyte injury, inflammatory processes and fibrosis. This is normally seen on liver biopsy and can range from milder forms (steatosis) to the more severe forms (non-alcoholic steatohepatitis (NASH), advanced fibrosis, cirrhosis and liver failure). In these patients, advanced fibrosis is the major predictor of morbidity and liver-related mortality, and an accurate diagnosis of NASH and NAFLD is mandatory. Histologic evaluation with liver biopsy remains the gold standard to diagnose NAFLD. Diagnosis of NAFLD is defined as presence of hepatic steatosis, ballooning and lobular inflammation with or without fibrosis. Weight loss, dietary modification, and the treatment of underlying metabolic syndrome remain the mainstays of therapy once the diagnosis is established. Dietary recommendations and lifestyle interventions, weight loss, and the treatment of underlying metabolic syndrome remain the mainstays of therapy once the diagnosis is established with promising results but are difficult to maintain. Pioglitazone and vitamin E are recommended by guidelines in selected patients. This review gives an overview of NAFLD and its treatment options.

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“…222 Considering the negative impact of obesity on liver transplantation, reports of bariatric surgery before or at the time of transplant have recently been published. 223 Carefully controlled studies are needed to determine the best timing for the bariatric procedure and liver transplantation in patients with obesity and NASH-cirrhosis needing a transplant. 224,225 These cases are recommended to be referred and treated in expert centres.…”

Section: H What Is the Role Of Bariatric Surgery?mentioning

confidence: 99%

Non-alcoholic fatty liver disease: A patient guideline

et al. 2021

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This patient guideline is intended for all patients at risk of or living with non-alcoholic fatty liver disease (NAFLD). NAFLD is the most frequent chronic liver disease worldwide and comes with a high disease burden. Yet, there is a lot of unawareness. Furthermore, many aspects of the disease are still to be unravelled, which has an important impact on the information that is given (or not) to patients. Its management requires a close interaction between patients and their many healthcare providers. It is important for patients to develop a full understanding of NAFLD in order to enable them to take an active role in their disease management. This guide summarises the current knowledge relevant to NAFLD and its management. It has been developed by patients, patient representatives, clinicians and scientists and is based on current scientific recommendations, intended to support patients in making informed decisions.

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Outcomes of Bariatric Surgery in Patients with Liver Cirrhosis: a Systematic Review

Abstract: Do w nlo a d e d fro m: h t t

Cited by 33 publications

References 39 publications

The use of very low‐calorie diets in subjects with obesity complicated with nonalcoholic fatty liver disease: A scoping review

The use of very low‐calorie diets in subjects with obesity complicated with nonalcoholic fatty liver disease: A scoping review

Non-alcoholic fatty liver disease (NAFLD): a review of pathophysiology, clinical management and effects of weight loss

Non-alcoholic fatty liver disease: A patient guideline

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