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Are Noninvasive Methods Comparable to Liver Biopsy in Postoperative Patients After Roux-en-Y Gastric Bypass?

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Abstract

Introduction

Transient tissue elastography (TTE) may estimate the degree of hepatic fibrosis in patients with obesity, but the method has restrictions that are mainly related to patients’ BMI.

Purpose

To compare the results of the evaluation of hepatic fibrosis by biochemical methods and TTE with those determined by liver biopsy in patients after RYGB.

Methods

This was a cross-sectional study involving patient data, TTE, and liver biopsy 1 year after RYGB.

Results

Of the 94 selected patients, 33 underwent TTE and liver biopsy. The average weight of patients was 84.4 ± 15.4 kg. The mean APRI was 0.2 ± 0.1, and 36 patients (97.3%) were classified as F0–F1. The average NFS was − 2.0 ± 1.0, with 25 patients (67%) classified as F0–F1 and 12 patients (32.4%) classified as F2. The agreement rate between Fibroscan and liver biopsy was 80.0%. Histological analysis revealed regression of inflammatory changes in all patients: 26 patients (72.2%) had some degree of non-alcoholic steatohepatitis (NAS ≥ 5), and after surgery, no patient presented inflammation upon biopsy. Nine patients (24.3%) had fibrosis at surgery, and only two (5.4%) still had fibrosis 1 year later (p < 0.008).

Conclusions

The use of APRI and Fibroscan is promising, but more studies are needed to evaluate patients with an advanced degree of NAFLD and confirm the entire spectrum of the disease.

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Authors and Affiliations

  1. Digestive Surgery Department, Hospital de Clinicas de Porto Alegre, Rua Ramiro Barcelos, 2350, Porto Alegre, Rio Grande do Sul, Brazil

    Pedro Funari Pereira, Vinicius Von Diemen, Eduardo Neubarth Trindade, Raphael Nicola Branchi & Manoel Roberto Maciel Trindade

  2. Gastroenterology Department, Hospital de Clinicas de Porto Alegre, Rua Ramiro Barcelos, 2350, Porto Alegre, Rio Grande do Sul, Brazil

    Matheus Truccolo Michalczuk & Mario Reis Alvares-da-Silva

  3. Pathology Department, Hospital de Clinicas de Porto Alegre, Rua Ramiro Barcelos, 2350, Porto Alegre, Rio Grande do Sul, Brazil

    Carlos Thadeu Schmidt Cerski & Debora Figueiro Aldabe

  4. Pathology Department, Centro de Anatomia Patológica, Rua General Osório, 1153, Pelotas, Rio Grande do Sul, Brazil

    Anderson Correa Mussi

  5. Faculty of Medicine, Universidade Federal do Rio Grande do Sul, Rua Ramiro Barcelos, 2400, Porto Alegre, Rio Grande do Sul, Brazil

    Pedro Glusman Knijnik & Pietro Waltrick Brum

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  1. Pedro Funari Pereira
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Correspondence to Pedro Funari Pereira.

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The study was performed in accordance with the ethical standards of the Declaration of Helsinki.

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Informed consent was obtained from all participants.

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Pereira, P.F., Von Diemen, V., Trindade, E.N. et al. Are Noninvasive Methods Comparable to Liver Biopsy in Postoperative Patients After Roux-en-Y Gastric Bypass?. OBES SURG 30, 2566–2571 (2020). https://doi.org/10.1007/s11695-020-04513-4

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