Therapeutic effects of sleeve gastrectomy for non-alcoholic steatohepatitis estimated by paired liver biopsy in morbidly obese Japanese patients
| Autor: | Akira Hiramatsu, Eisuke Murakami, Masayasu Yoneda, Yui Nishimura, Masataka Tsuge, Daisuke Iwaki, Michio Imamura, Daichi Jodai, Takashi Nakahara, Hatsue Fujino, Hideki Ohdan, Yoshihiro Saeki, Akiko Nagao, Kazuaki Chayama, Yusuke Minamoto, Toshikazu Ohigashi, Tomokazu Kawaoka, Kei Morio, Kazuaki Tanabe, Masami Yamauchi, Hiroshi Aikata, Kenichi Fudeyasu, Yuki Nakashima |
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| Rok vydání: | 2021 |
| Předmět: |
Liver Cirrhosis
Male Sleeve gastrectomy medicine.medical_specialty medicine.medical_treatment Biopsy Bariatric Surgery Observational Study Gastroenterology Body Mass Index Time 03 medical and health sciences 0302 clinical medicine Japan Liver Function Tests Gastrectomy Non-alcoholic Fatty Liver Disease Internal medicine medicine Humans 030212 general & internal medicine liver biopsy medicine.diagnostic_test business.industry Therapeutic effect Fatty liver Remission Induction Retrospective cohort study General Medicine Middle Aged medicine.disease Comorbidity Obesity Morbid morbid obesity Liver 030220 oncology & carcinogenesis Liver biopsy Female Laparoscopy non-alcoholic steatohepatitis Steatohepatitis business Body mass index sleeve gastrectomy Research Article |
| Zdroj: | Medicine |
| ISSN: | 1536-5964 |
| Popis: | Bariatric surgery has been reported to improve non-alcoholic steatohepatitis (NASH), which is a frequent comorbidity in morbidly obese patients. We performed a retrospective cohort study to estimate the therapeutic effect of sleeve gastrectomy (SG), the most common bariatric surgery in Japan, on obese patients with NASH by comparing the findings of paired liver biopsies. Eleven patients who underwent laparoscopic SG for the treatment of morbid obesity, defined as body mass index (BMI) > 35 kg/m2, from March 2015 to June 2019 at Hiroshima University Hospital, Japan, were enrolled. All patients were diagnosed with NASH by liver biopsy before or during SG and were re-examined with a second liver biopsy 1 year after SG. The clinical and histological characteristics were retrospectively analyzed. One year after SG, body weight and BMI were significantly reduced, with median reductions in body weight and BMI of—22 kg and –7.9 kg/m2, respectively. Body fat was also significantly reduced at a median of 13.7%. Liver-related enzymes were also significantly improved. On re-examination by paired liver biopsy, liver steatosis improved in 9 of the 11 patients (81.8%), ruling out of the pathological diagnosis of NASH. However, fibrosis stage did not significantly improve 1 year after SG. The non-alcoholic fatty liver disease activity score was significantly reduced in 10 of 11 patients (90.9%). Pathological improvement or remission of NASH could be achieved in most morbidly obese Japanese patients 1 year after SG. |
| Databáze: | OpenAIRE |
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