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Impact of gastric bypass surgery on the liver fibrosis of patients with extreme obesity and nonalcoholic fatty liver disease in 30-month follow-up

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Abstract

Roux-en-Y gastric bypass surgery (RYGB) has shown efficacy in weight loss, but its role in liver fibrosis remains unknown and contentious. The present study aimed to investigate the effect of RYGB on liver fibrosis measured by non-invasive methods and assess the impact of weight loss on hepatic fibrosis in the midterm follow-up after RYGB. This longitudinal study was conducted on patients with extreme obesity, and NAFLD referred for RYGB during 2016–2018 for 3 years after their surgery. A liver biopsy was performed intraoperatively. The patient demographics, anthropometrical parameters, biochemical variables, and Liver stiffness (LS) using two-dimensional shear-wave elastography were recorded and analyzed before and in short-term and midterm follow-ups. Fifty-four patients were included with a mean age of 40.3 years; 83.3% were women. At a median follow-up of 30 months (range: 24–36 months), the excessive body mass index loss of the patients was 78.1% and, a significant reduction was seen in LS measurement. Two patients (4%) had worsening showed in the fibrosis stage, 28 (54%) no change, and 24 (42%) showed improvement, 30 months after the surgery. Moreover, the liver fibrosis stage regressed to F0 in 91% of the patients. Hepatic fibrosis resolved in the midterm follow-up in some patients whose fibrosis had progressed and deteriorated in the short-term follow-up. In addition, Liver enzymes were decreased. RYGB seems to be an effective procedure for sustained weight loss and improved liver fibrosis in EO and NAFLD patients in midterm follow-up.

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Availability of data

The datasets generated during and analysed during the current study are available from the corresponding author on reasonable request.

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Acknowledgements

The authors are thankful to all patients for their assistance in completing the 24 h dietary recall questionnaire.

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None declared.

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Author notes

  1. Ali Jangjoo and Mohsen Nematy have contributed equally to Corresponding.

Authors and Affiliations

  1. Department of Nutrition, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran

    Andisheh Norouzian Ostad, Tannaz Jamialahmadi, Golnaz Ranjbar & Reza Rezvani

  2. Department of Radiology, Faculty of Medicine, Islamic Azad University-Mashhad Branch, Mashhad, Iran

    Farnood Rajabzadeh

  3. Gastroenterology and Hepatology Research Center, Mashhad University of Medical Sciences, Mashhad, Iran

    Ladan Goshayeshi

  4. Department of Gastroenterology and Hepatology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran

    Ladan Goshayeshi

  5. Department of Nutritional Sciences, Faculty of Medicine Mashhad, Metabolic Syndrome Research Center, University of Medical Sciences, Mashhad University of Medical Sciences, Mashhad, Iran

    Mohsen Nematy

  6. Department of General Surgery, Cancer Surgery Research Center, Surgical Oncology Research Center, Mashhad University of Medical Sciences, Mashhad, Iran

    Ali Jangjoo

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  1. Andisheh Norouzian Ostad
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Contributions

Protocol/project development: J, NO, N, J, R and, G. Data collection or management: NO, J, N, J. Data analysis: NO and K-R. Manuscript writing/editing: NO, JR, and K-R.

Corresponding authors

Correspondence to Mohsen Nematy or Ali Jangjoo.

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The authors declare that they have no competing interests. None declared.

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All the procedures performed in this study that involved human participants were in accordance with the ethical standards of the institutional and/or national research committee and the Declaration of Helsinki (1964).

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Informed consent was obtained from all the patients prior to enrollment.

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Norouzian Ostad, A., Rajabzadeh, F., Jamialahmadi, T. et al. Impact of gastric bypass surgery on the liver fibrosis of patients with extreme obesity and nonalcoholic fatty liver disease in 30-month follow-up. Updates Surg 75, 659–669 (2023). https://doi.org/10.1007/s13304-022-01421-3

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