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Long-term effects of one-anastomosis gastric bypass on liver histopathology in NAFLD cases: a prospective study

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Abstract

Purpose

Weight reduction can effectively improve nonalcoholic fatty liver disease (NAFLD), which is a constant companion of severe obesity. This study aimed to determine the effect of one-anastomosis gastric bypass (OAGB) on pathological liver changes in severely obese cases with NAFLD.

Methods

The present prospective research comprised 67 subjects with morbid obesity scheduled for OAGB during the period from February 2015 to August 2018. Clinical, biological, and histologic data were evaluated pre and 15 months postoperatively.

Results

Fifteen months after surgery, a considerable reduction was noted in the grades of fat deposition, liver cell ballooning, and lobular inflammatory changes, in addition to the total NAS score. Fifteen months after surgery, nonalcoholic steatohepatitis (NASH) disappeared in 42% of the patients. A significant regression of fibrosis stage occurred after surgery in 79.1% of patients (p < 0.001). After surgery, patients had substantial reductions in aspartate aminotransferase, alanine aminotransferase, γ-glutamyltransferase, HbA1c, total cholesterol, and Low-density lipoprotein (p < 0.001, for all comparisons). Diabetes mellitus, hypertension, and dyslipidemia resolved in 54%, 59%, and 69% of the patients, respectively.

Conclusion

OAGB resolved NASH from nearly 42% of patients and reduced the histological features of NAFLD 15 months after surgery. Bariatric procedures might be adopted as a therapeutic modality in severely obese cases with NAFLD after the failure of lifestyle modifications.

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Funding

This study was supported by the authors. No other fund was received.

Author information

Authors and Affiliations

  1. General Surgery Department, Faculty of Medicine, Cairo University, Cairo, Egypt

    Mohamed Abdalla Salman, Haitham S. E. Omar, Ahmed Abdelsalam & Mohamed Saber Mostafa

  2. Internal Medicine Department, Faculty of Medicine, Cairo University, Cairo, 11311, Egypt

    Ahmed Abdallah Salman

  3. General Surgery Department, Omm Elmisrien General Hospital, Cairo, Egypt

    Mohamed Tourky

  4. General Surgery Department, Faculty of Medicine, Al-Azhar University, Cairo, Egypt

    Ahmed Abd El Aal Sultan, Mohammed Hassan Elshafey, Walid Rafat Abdelaty, Abdoh Salem, Osama Osman Khaliel & Mohammed A. Nafea

  5. General Surgery Department, Faculty of Medicine, Helwan University, Cairo, Egypt

    Hossam E. Elshafey

  6. National Hepatology and Tropical Medicine Research Institute, Cairo, Egypt

    Mohamed Atallah & Hossam El-Din Shaaban

  7. Tropical Medicine Department, Faculty of Medicine, Cairo University, Cairo, Egypt

    Mohamed Yousef

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  1. Mohamed Abdalla Salman
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Corresponding author

Correspondence to Ahmed Abdallah Salman.

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Disclosures

Drs. Mohamed Abdalla Salman, Ahmed Abdallah Salman, Haitham SE Omar, Ahmed Abdelsalam, Mohamed Saber Mostafa, Mohamed Tourky, Ahmed Abd El Aal Sultan, Mohammed Hassan Elshafey, Walid Rafat Abdelaty, Abdoh Salem, Osama Osman Khaliel, Hossam E Elshafey, Mohamed Atallah, Hossam El-Din Shaaban, Mohamed Yousef, and Mohammed A Nafea have no conflicts of interest or financial ties to disclose.

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Salman, M.A., Salman, A.A., Omar, H.S.E. et al. Long-term effects of one-anastomosis gastric bypass on liver histopathology in NAFLD cases: a prospective study. Surg Endosc 35, 1889–1894 (2021). https://doi.org/10.1007/s00464-020-07725-y

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