Bariatric surgery improves histological features of nonalcoholic fatty liver disease and liver fibrosis
| Autor: | Donald E. Wheeler, John Paul Gonzalvo, Andrew A. Taitano, Michael Markow, Jon Finan, Michel M. Murr |
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| Rok vydání: | 2014 |
| Předmět: |
Adult
Liver Cirrhosis Male medicine.medical_specialty Cirrhosis Biopsy Bariatric Surgery Gastroenterology Hepatitis Young Adult Fibrosis Non-alcoholic Fatty Liver Disease Internal medicine Nonalcoholic fatty liver disease Prevalence Medicine Humans Single-Blind Method Young adult Aged medicine.diagnostic_test business.industry Middle Aged medicine.disease Obesity Surgery Obesity Morbid Liver Female Steatohepatitis Steatosis business |
| Zdroj: | Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract. 19(3) |
| ISSN: | 1873-4626 |
| Popis: | Nonalcoholic fatty liver disease (NAFLD) is prevalent in obese patients. We sought to determine the effects of bariatric surgery on the histological features of NAFLD. Two blinded pathologists graded liver biopsies done during bariatric procedures and subsequent operations in 160 patients using the Brunt classification. Data are mean ± SD. Interval between biopsies was 31 ± 26 months. Initial biopsies demonstrated steatosis 77 %, lobular inflammation 39 %, and chronic portal inflammation 56 %. Steatohepatitis was present in 27 %. Grade 2–3 fibrosis was present in 27 %, and cirrhosis was present in one patient. On post-bariatric biopsy, steatosis resolved in 75 %, lobular inflammation resolved in 75 %, chronic portal inflammation resolved in 49 %, and steatohepatitis resolved in 90 %. Fibrosis of any grade resolved in 53 % and improved in another 3 % of patients. Grade 2 fibrosis resolved in 58 %, improved in 3 %, and did not worsen in 11 %. Bridging fibrosis resolved in 29 %, improved in 29 %, and did not worsen in 29 %. Bariatric surgery is associated with resolution of steatosis or steatohepatitis in the majority of patients. More importantly, grade 2 or 3 (bridging) fibrosis is resolved or improved in 60 % of patients. Bariatric surgery should be considered as a treatment of NAFLD in severely obese patients. |
| Databáze: | OpenAIRE |
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