Radiographic Improvement of Hepatic Steatosis After Laparoscopic Roux-en-Y Gastric Bypass

Winder, Joshua S.; Dudeck, Brandon; Schock, Sarayna; Lyn-Sue, Jerome; Haluck, Randy S.; Rogers, Ann M.

doi:10.1007/s11695-016-2299-5

Cited by 7 publications

(4 citation statements)

References 16 publications

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“…Weight loss has been associated with biochemical, 28 radiographic, 29,30 and histologic 31,32 improvements in NAFLD, but initial weight loss may be a challenge and maintaining lower weight after weight loss is difficult over time. 33 Weight loss and physical activity are the recommended treatments for NAFLD.…”

Section: Discussionmentioning

confidence: 99%

Body mass index trajectories in young adulthood predict non‐alcoholic fatty liver disease in middle age: The CARDIA cohort study

VanWagner

Khan

Ning

et al. 2017

Liver International

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Section: Discussionmentioning

confidence: 99%

Body mass index trajectories in young adulthood predict non‐alcoholic fatty liver disease in middle age: The CARDIA cohort study

VanWagner

Khan

Ning

et al. 2017

Liver International

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“…A decrease in hepatic left lobe volume on ultrasound was also observed after two years in 75 women who underwent laparoscopic AGB[98]. Two small studies found improvements in liver damage and NAFLD using ultrasound imaging[99] and CT[100].…”

Section: Hepatic Effects Of Bariatric Surgerymentioning

confidence: 99%

Bariatric surgery in patients with non-alcoholic fatty liver disease - from pathophysiology to clinical effects

Laursen

Hagemann

Wei

et al. 2019

WJH

136

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Non-alcoholic fatty liver disease (NAFLD) is increasingly recognized as a significant liver disease, and it covers the disease spectrum from simple steatosis with a risk of development of non-alcoholic steatohepatitis (NASH) to fibrosis, subsequent cirrhosis, end-stage liver failure, and liver cancer with a potential need for liver transplantation. NAFLD and NASH are closely related to obesity, metabolic syndrome, and type 2 diabetes (T2D). The role of gut hormones, especially glucagon-like peptide 1 (GLP-1), is important in NAFLD. Bariatric surgery has the potential for inducing great weight loss and may improve the symptoms of metabolic syndrome and T2D. Recent data demonstrated significant effects of bariatric surgery on GLP-1 and other gut hormones and important lipid metabolic and inflammatory abnormalities in the pathophysiology of NAFLD. Therefore, bariatric surgery may reverse the pathological liver changes in NAFLD and NASH patients. In the present review, we describe NAFLD and NASH pathophysiology and the primary effects of bariatric surgery on metabolic pathways. We performed a systematic review of the beneficial and harmful effects and focused on changes in liver disease severity in NAFLD and NASH patients. The specific focus was liver histopathology as assessed by the invasive liver biopsy. Additionally, we reviewed several non-invasive methods used for the assessment of liver disease severity following bariatric surgery.

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“…A recent meta-analysis indicated that 91% of patients undergoing RYGB experienced a reduction in the histological severity of liver steatosis after surgery [15]. Consistent with these observations, a study by Winder et al indicated a reduction in steatosis grade in 84% of patients after RYGB surgery [16]. When looking specifically at steatohepatitis, de Almeida et al reported a complete resolution of necroinflammatory changes and an improvement of liver fibrosis in all NASH patients undergoing RYGB [17].…”

Section: Discussionmentioning

confidence: 81%

Impact of Nonalcoholic Steatohepatitis on the Outcome of Patients Undergoing Roux-en-Y Gastric Bypass Surgery: a Propensity Score–Matched Analysis

et al. 2021

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Purpose It is currently unknown whether NASH (nonalcoholic steatohepatitis), as compared to simple steatosis, is associated with impaired postoperative weight loss and metabolic outcomes after RYGB surgery. To compare the effectiveness of Roux-en-Y gastric bypass (RYGB) on patients with NASH versus those with simple nonalcoholic fatty liver (NAFL). Materials and Methods We retrospectively retrieved data from 515 patients undergoing RYGB surgery with concomitant liver biopsy. Clinical follow-up and metabolic assessment were performed prior to surgery and 12 months after surgery. We used multivariate analysis of variance (MANOVA) and propensity score matching and we assessed for changes in markers of hepatocellular injury and metabolic outcomes. Results There were 421 patients with simple NAFL, and 94 with NASH. Baseline alanine and aspartate aminotransferases were significantly higher in patients with NASH (p < 0.01). Twelve months after the RYGB surgery, as determined by both MANOVA and propensity score matching, patients with NASH exhibited a significantly greater reduction in alanine aminotransferase (ß-coefficient − 12 iU/l [− 22 to − 1.83], 95% CI, adjusted p = 0.021) compared to their NAFL counterparts (31 matched patients in each group with no loss to follow-up at 12 months). Excess weight loss was similar in both groups (ß-coefficient 4.54% [− 3.12 to 12.21], 95% CI, adjusted p = 0.244). Change in BMI was comparable in both groups (− 14 (− 16.6 to − 12.5) versus − 14.3 (− 17.3 to − 11.9), p = 0.784). Conclusion After RYGB surgery, patients with NASH experience a greater reduction in markers for hepatocellular injury and similar weight loss compared to patients with simple steatosis.

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Radiographic Improvement of Hepatic Steatosis After Laparoscopic Roux-en-Y Gastric Bypass

Abstract: While weight loss and comorbidity improvement are common, they are not universal after LRYGB. Radiographic improvement of NAFLD in 84 % of patients was salutary.

Cited by 7 publications

References 16 publications

Body mass index trajectories in young adulthood predict non‐alcoholic fatty liver disease in middle age: The CARDIA cohort study

Body mass index trajectories in young adulthood predict non‐alcoholic fatty liver disease in middle age: The CARDIA cohort study

Bariatric surgery in patients with non-alcoholic fatty liver disease - from pathophysiology to clinical effects

Impact of Nonalcoholic Steatohepatitis on the Outcome of Patients Undergoing Roux-en-Y Gastric Bypass Surgery: a Propensity Score–Matched Analysis

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