Systematic review and meta-analysis of Roux-en-Y gastric bypass against laparoscopic sleeve gastrectomy for amelioration of NAFLD using four criteria

Baldwin, Dustin; Chennakesavalu, Mohansrinivas; Gangemi, Antonio

doi:10.1016/j.soard.2019.09.060

Cited by 50 publications

(52 citation statements)

References 41 publications

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“…Bariatric surgery presents an accepted treatment modality for NAFLD [ 6 , 11 , 12 , 17 , 25 , 26 ]. However, evidence on the modality of choice with regard to NAFLD (SG or RYGB) is sparse and a statement regarding the operative approach is lacking in the guidelines [ 26 , 27 ].…”

Section: Discussionmentioning

confidence: 99%

“…The positive impact of bariatric surgery on altitude of liver enzyme elevation has been assessed in a large prospective intervention study [ 11 ]. Histologically, grade of NAFLD ameliorates after bariatric surgery, as measured by NAFLD activity score (NAS) [ 6 , 9 , 12 – 14 ]. Even liver fibrosis can be resolved after bariatric surgery in some cases [ 6 , 9 , 14 – 17 ].…”

Section: Introductionmentioning

confidence: 99%

“…As of today, the right surgical procedure as a treatment option for patients with NAFLD is subject to intense discussions. Some studies suggest sleeve gastrectomy (SG) and Roux-en-Y-gastric bypass (RYGB) to be of equal effectiveness in amelioration of NAFLD [ 10 , 12 , 13 ], while others favor either RYGB [ 6 , 17 , 20 ] or SG [ 5 , 16 , 21 ]. Thus, the aim of this study was to compare postoperative recovery of liver function between RYGB and SG and to assess risk factors for potential deterioration of liver function capacity.…”

Section: Introductionmentioning

confidence: 99%

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Comparison of Liver Recovery After Sleeve Gastrectomy and Roux-en-Y-Gastric Bypass

et al. 2021

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Background Nonalcoholic fatty liver disease (NAFLD) is a common condition in patients with obesity. Bariatric surgery has often been proposed as a viable treatment option, but the ideal surgical procedure remains unclear. Inconsistently, reports on postoperative deterioration of liver function put further doubt on which technique to apply. Aim of this study was to assess the impact of Roux-en-Y-gastric bypass (RYGB) and sleeve gastrectomy (SG) on the postoperative recovery of liver function. Methods A total of 175 patients with obesity that underwent bariatric surgery in our institution were included in this prospective cohort study. BMI, laboratory values, and liver function capacity (using LiMAx) were assessed preoperatively and at 6 and 12 months postoperatively. Generalized linear model (GLM) was performed to determine variables influencing liver function capacity after the operation. Results Prior to operations, 64% of patients presented with a diminished liver function capacity, as measured by LiMAx test. Liver function capacity significantly recovered after 12 months in the SG group (300 μg/kg/h preop vs. 367 μg/kg/h postop) but not in the RYGB group (306 μg/kg/h preop vs. 349 μg/kg/h). Preoperative factors impeding liver function recovery included type 2 diabetes mellitus (T2DM), weight, male sex, AST/thrombocyte ratio (APRI), and gamma-glutamyltransferase (GGT). Conclusion Bariatric surgery, especially sleeve gastrectomy, leads to an improvement of liver function. However, in some patients with T2DM, higher preoperative weight and male sex postoperative deterioration of liver function capacity may occur. Graphical abstract

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Comparison of Liver Recovery After Sleeve Gastrectomy and Roux-en-Y-Gastric Bypass

et al. 2021

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“…Hereby, both RYGB and SG proved to be similarly effective [39]. RYGB and SG surgery also significantly improved alanine aminotransferase, aspartate aminotransferase, NAFLD activity score and NAFLD fibrosis score [37]. Hepatic insulin resistance was markedly decreased post-surgery, while beta cell function improved due to an increase in postprandial GLP-1 level [40,41].…”

Section: Impact Of Gastric Bypass Surgery On Gut Microbiotamentioning

confidence: 78%

“…Bariatric surgery significantly helps to ameliorate biochemical and histologic parameters in patients with NAFLD [37]. Steatosis, Steatohepatitis and liver fibrosis are improved in the majority of patients after surgery [38].…”

Section: Impact Of Gastric Bypass Surgery On Gut Microbiotamentioning

confidence: 99%

Microbial Adaptation Due to Gastric Bypass Surgery: The Nutritional Impact

2020

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Bariatric surgery leads to sustained weight loss and the resolution of obesity-related comorbidities. Recent studies have suggested that changes in gut microbiota are associated with the weight loss induced by bariatric surgery. Several studies have observed major changes in the microbial composition following gastric bypass surgery. However, there are inconsistencies between the reported alterations in microbial compositions in different studies. Furthermore, it is well established that diet is an important factor shaping the composition and function of intestinal microbiota. However, most studies on gastric bypass have not assessed the impact of dietary intake on the microbiome composition in general, let alone the impact of restrictive diets prior to bariatric surgery, which are recommended for reducing liver fat content and size. Thus, the relative impact of bariatric surgery on weight loss and gut microbiota remains unclear. Therefore, this review aims to provide a deeper understanding of the current knowledge of the changes in intestinal microbiota induced by bariatric surgery considering pre-surgical nutritional changes.

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European guideline on obesity care in patients with gastrointestinal and liver diseases – Joint European Society for Clinical Nutrition and Metabolism / United European Gastroenterology guideline

et al. 2022

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Systematic review and meta-analysis of Roux-en-Y gastric bypass against laparoscopic sleeve gastrectomy for amelioration of NAFLD using four criteria

Cited by 50 publications

References 41 publications

Comparison of Liver Recovery After Sleeve Gastrectomy and Roux-en-Y-Gastric Bypass

Comparison of Liver Recovery After Sleeve Gastrectomy and Roux-en-Y-Gastric Bypass

Microbial Adaptation Due to Gastric Bypass Surgery: The Nutritional Impact

European guideline on obesity care in patients with gastrointestinal and liver diseases – Joint European Society for Clinical Nutrition and Metabolism / United European Gastroenterology guideline

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