The effect of bariatric surgery on non-alcoholic fatty liver disease is still controversial. In most cases, bariatric surgery results in hepatic improvement, but sometimes it can lead to impairment. We systematically reviewed the English literature for reports of stunting or deterioration of hepatic histology following bariatric surgeries through sequential liver biopsies to show the possibility of this negative occurrence by gathering all the reports regarding this event until March 2018. Underlying mechanisms, patient characteristics, possible risk factors, preventative strategies, presenting signs and symptoms, and available management options are discussed. This paper concludes that although rare, hepatic decompensation following bariatric surgeries can occur. Therefore, bariatric surgeons should be aware of the ways to prevent, monitor, and manage hepatic impacts.
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