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Obesity Surgery

, Volume 30, Issue 1, pp 87–95 | Cite as

Laparoscopic Sleeve Gastrectomy on the Horizon as a Promising Treatment Modality for NAFLD

  • Mohamed Abdalla Salman
  • Ahmed Abdallah SalmanEmail author
  • Ahmed Abdelsalam
  • Mohamed Atallah
  • Hossam El-Din Shaaban
  • Ahmed El-Mikkawy
  • Mahmoud Gouda Omar
  • Mai Elshenoufy
Original Contributions
  • 168 Downloads

Abstract

Introduction

Nonalcoholic fatty liver disease (NAFLD) is viewed as the hepatic manifestation of the metabolic syndrome with hepatic fatty infiltration is the common liver pathology. NAFLD can lead to nonalcoholic steatohepatitis (NASH), liver cirrhosis, liver cell failure, and liver malignancy.The present work aims to prospectively study the histological changes that occur in NAFLD obese patients 1-year post-laparoscopic sleeve gastrectomy (LSG) based on standardized NAS (NAFLD activity score).

Patients

This prospective study included 94 obese patients who underwent laparoscopic sleeve gastrectomy. Intraoperative wedge liver biopsy was taken from all patients with a follow-up liver biopsy at 12 months after the operation.

Results

LSG produced a marked reduction in body weight with a mean reduction in BMI from 44.54 + 5.45 to 34.23 + 2.66 kg/m2 at 12 months. There were statistically highly significant improvements regarding metabolic comorbidities, blood pressure, lipid profile, and HbA1C at 12-month post-LSG (P < 0.001). The current study showed a highly statistically significant improvement at 1-year post LSG regarding steatosis grade, hepatocyte ballooning, lobular inflammation as well as fibrosis stage (P < 0.001). Moreover, the present study showed that NAS score significantly decreased from 5.20 + 1.96 at baseline to 2.63 + 1.55 at 1-year follow-up (P < 0.001).

Conclusion

Our relatively large patient cohort shows a significant improvement of steatosis, steatohepatitis, and fibrosis at a 1-year follow-up. LSG can lead to resolution of NAFLD, and it may be in the near future another routine indication for bariatric surgery.

Keywords

Laparoscopic sleeve gastrectomy NAFLD 

Notes

Funding

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

Compliance with Ethical Standards

Conflict of Interest

The authors declare that they have no conflict of interest.

Informed Consents

Informed consents were obtained from all patients included in the study at all appropriate stages.

Ethics Approval

This study was approved by the Institutional Review Board/Clinical Medical Research Ethics Committee.

Supplementary material

11695_2019_4118_MOESM1_ESM.xlsx (34 kb)
ESM 1 (XLSX 33 kb)

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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  • Mohamed Abdalla Salman
    • 1
  • Ahmed Abdallah Salman
    • 2
    Email author
  • Ahmed Abdelsalam
    • 1
  • Mohamed Atallah
    • 3
  • Hossam El-Din Shaaban
    • 3
  • Ahmed El-Mikkawy
    • 4
  • Mahmoud Gouda Omar
    • 2
  • Mai Elshenoufy
    • 2
  1. 1.General Surgery Department, Faculty of MedicineCairo UniversityCairoEgypt
  2. 2.Internal Medicine Department, Faculty of MedicineCairo UniversityCairoEgypt
  3. 3.National Hepatology and Tropical Medicine Research InstituteCairoEgypt
  4. 4.Hepatology and Gastroenterology DepartmentTheodor Bilharz Research InstituteGizahEgypt

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