The Effect of Laparoscopic Sleeve Gastrectomy on Nonalcoholic Fatty Liver Disease

Abstract

Obesity is associated with nonalcoholic fatty liver disease which is one of the most common causes of chronic liver disease. FibroScan is a noninvasive tool for liver stiffness measurement and controlled attenuation parameter to evaluate liver steatosis and fibrosis. We aimed to demonstrate the effect of laparoscopic sleeve gastrectomy on liver steatosis and fibrosis. Of the 120 consecutive patients screened, 72 were enrolled in this study. FibroScan M probe and XL probe were used for the evaluation of liver steatosis and fibrosis. Fiftytwo patients (72.2%) were female individuals and 20 (27.8%) were male individuals; the mean age was 37.9 ± 10.4 years. Percentage of excess weight loss was significant at the third and sixth months: 57.2 ± 18.3 (P < 0.05) and 81.4 ± 24.6 (P < 0.05), respectively. Mean preoperative controlled attenuation parameter and liver stiffness measurement values were 309.2 ± 68.7 dB/m and 7.5 ± 5.0 kPa, respectively, and significantly declined to 217.4 ± 56.4 dB/m and 5.6 ± 2.5 kPa, respectively, at sixth postoperative month (P < 0.001 and <0.01, respectively). These results suggest that laparoscopic sleeve gastrectomy is associated with significant improvement in liver steatosis and fibrosis. Bariatric surgery has a beneficial effect on nonalcoholic fatty liver disease in morbidly obese patients.

Does Neutrophil-Lymphocyte Ratio Correlate with the Improvement of Hepatosteatosis after Laparoscopic Sleeve Gastrectomy?

“…Nonalkolik steatohepatit is the most common chronic liver disease, with a prevalence rate of up to 90% in morbidly obese people. It can progress to liver fibrosis and even cirrhosis [7, 18, 19]. Liver biopsy is the gold standard technique in the diagnosis of hepatosteatosis; however, it is an invasive method [20].…”

“…LSG is the most common bariatric procedure around the world [21][22][23]. Improvement of hepatosteatosis has been reported with a decrease in BMI after LSG [6,7,24]. Esquivel et al [25] showed that all the participating patients reversed or reduced the stage of hepatosteatosis 1 year after LSG.…”

“…The same radiologist performed grayscale USG examinations on patients using a 3.5-MHz convex probe and a Samsung RS80A device after they had fasted for at least 8 h. The degree of steatosis in the liver was classified as normal (grade 0), mild (grade 1), moderate (grade 2), or severe (grade 3) based on the degree of increased echo of the liver parenchyma and whether the echo of the intrahepatic vascular structures and diaphragm was clearly seen in the fatty liver with increased echo [7].…”

“…Endo et al [6] reported improvement in nonalcoholic fatty liver disease after LSG was performed on obese Japanese patients. Batman et al [7] demonstrated that LSG is associated with a significant improvement in liver steatosis.…”

Foregut bypass vs. restrictive bariatric procedures for nonalcoholic fatty liver disease: a meta-analysis of 3,355 individuals

“…After 1,462 articles were excluded based on study title and abstract, 136 articles were selected for full text review, of which 31 articles met the final inclusion criteria (Figure 2). In total, five articles originated from the United States (36)(37)(38)(39)(40), six from Brazil (41)(42)(43)(44)(45)(46), four from France (18,(47)(48)(49), two from Poland (50,51), Australia (52,53) and Japan (54,55) respectively and one each from Denmark (56), Canada (57), Germany (58), Greece (59), India (60), Israel (61), Netherlands (62), Saudi Arabia (63), Taiwan (64) and Turkey (65). Of the 31 included articles, there were 20 single-arm and 11 doublearm studies.…”