Gasric bypass surgery markedly improves liver histology in patients with nonalcoholic steatohepatitis

A decision analysis study of the value of a liver biopsy in nonalcoholic steatohepatitis

“…The overall efficacy of caloric restriction for the treatment of NAFLD was determined to be 61% based on two studies of liver histology before and after caloric restriction for 261–365 days (30, 31). The efficacy of medical and surgical intervention was estimated to be 59% (Table 4) (15, 32–40), with the greatest efficacy noted to be 86% based on a study by Clark et al (15) who compared liver histology at the time of Roux‐en‐y gastric bypass and at elective incisional hernia repair in 16 patients at a mean follow‐up time of 305 days. The rate of severe complications from lifestyle interventions was determined to be zero.…”

“… Probability was determined based on percentage of patients with regression of types 3 or 4 NAFLD on follow‐up biopsy compared with initial biopsy after intervention (15, 32–40). …”