Assessment of Metabolic and Bariatric Surgery Safety in Patients with Advanced Liver Fibrosis.

Autor: Barum G; Universidade Federal de Ciências da Saúde de Porto Alegre, R. Sarmento Leite, 245 - Centro Histórico, Porto Alegre, RS, 90050-170, Brazil.; Obesity Treatment Center, Irmandade Santa Casa de Misericórdia de Porto Alegre, Av. Independência, 155 - Independência, Porto Alegre, RS, 90035-074, Brazil., Paladini LA; Universidade Federal de Ciências da Saúde de Porto Alegre, R. Sarmento Leite, 245 - Centro Histórico, Porto Alegre, RS, 90050-170, Brazil., de Oliveira PGS; Universidade Federal de Ciências da Saúde de Porto Alegre, R. Sarmento Leite, 245 - Centro Histórico, Porto Alegre, RS, 90050-170, Brazil., Moreira TR; Universidade Federal de Ciências da Saúde de Porto Alegre, R. Sarmento Leite, 245 - Centro Histórico, Porto Alegre, RS, 90050-170, Brazil., Tovo CV; Universidade Federal de Ciências da Saúde de Porto Alegre, R. Sarmento Leite, 245 - Centro Histórico, Porto Alegre, RS, 90050-170, Brazil.; Department of Gastroenterology and Hepatology, Irmandade Santa Casa de Misericórdia de Porto Alegre, Av. Independência, 155 - Independência, Porto Alegre, RS, 90035-074, Brazil., Mattos ÂZ; Universidade Federal de Ciências da Saúde de Porto Alegre, R. Sarmento Leite, 245 - Centro Histórico, Porto Alegre, RS, 90050-170, Brazil. angeloz@ufcspa.edu.br.; Department of Gastroenterology and Hepatology, Irmandade Santa Casa de Misericórdia de Porto Alegre, Av. Independência, 155 - Independência, Porto Alegre, RS, 90035-074, Brazil. angeloz@ufcspa.edu.br.; Federal University of Health Sciences of Porto Alegre, Rua Sarmento Leite, 245, Centro Histórico, Porto Alegre, RS, 90050-170, Brazil. angeloz@ufcspa.edu.br.
Jazyk: angličtina
Zdroj: Obesity surgery [Obes Surg] 2024 Sep; Vol. 34 (9), pp. 3173-3180. Date of Electronic Publication: 2024 Jul 30.
DOI: 10.1007/s11695-024-07434-8
Abstrakt: Purpose: The well-established relationship between obesity and metabolic dysfunction-associated steatotic liver disease (MASLD) is a key etiological factor in the development of liver cirrhosis. Bariatric surgery is an effective treatment for weight loss in patients with moderate-to-severe obesity, also playing a role in controlling MASLD. However, surgical safety in patients with advanced fibrosis remains to be established. This study aimed to evaluate the safety and repercussions of bariatric surgery according to fibrosis stage.
Materials and Methods: Patients undergoing bariatric surgery who had an intraoperative liver biopsy were retrospectively evaluated. Preoperative and postoperative data were collected from medical records, and results were stratified according to fibrosis stage into early fibrosis (no fibrosis or stages 1 and 2) and advanced fibrosis (stages 3 and 4).
Results: The study included 1185 patients: 1129 with early fibrosis and 56 with advanced fibrosis. The advanced fibrosis group had higher percentage of men (35.7% vs 21.6%, p = 0.014) and of people with diabetes (42.9% vs 16.5%, p < 0.001) and hypertension (57.1% vs 41.4%, p = 0.012). Patients with advanced fibrosis also required longer hospitalizations (4.64 vs 4.06 days, p < 0.001) and were more frequently admitted to the intensive care unit (7.1% vs 2.9%, p = 0.038). The groups did not differ significantly in other outcomes. There were no deaths in either group.
Conclusion: Bariatric surgery proved to be safe, with similar complication rates in patients with advanced fibrosis and in those with early fibrosis.
(© 2024. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)
Databáze: MEDLINE
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