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

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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.

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Funding

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

Author information

Authors and Affiliations

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

    Mohamed Abdalla Salman & Ahmed Abdelsalam

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

    Ahmed Abdallah Salman, Mahmoud Gouda Omar & Mai Elshenoufy

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

    Mohamed Atallah & Hossam El-Din Shaaban

  4. Hepatology and Gastroenterology Department, Theodor Bilharz Research Institute, Gizah, Egypt

    Ahmed El-Mikkawy

Authors
  1. Mohamed Abdalla Salman
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  2. Ahmed Abdallah Salman
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  3. Ahmed Abdelsalam
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  4. Mohamed Atallah
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  5. Hossam El-Din Shaaban
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  6. Ahmed El-Mikkawy
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  7. Mahmoud Gouda Omar
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  8. Mai Elshenoufy
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Corresponding author

Correspondence to Ahmed Abdallah Salman.

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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.

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Salman, M.A., Salman, A.A., Abdelsalam, A. et al. Laparoscopic Sleeve Gastrectomy on the Horizon as a Promising Treatment Modality for NAFLD. OBES SURG 30, 87–95 (2020). https://doi.org/10.1007/s11695-019-04118-6

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  • DOI: https://doi.org/10.1007/s11695-019-04118-6

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