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A Systematic Review of Bariatric Surgery in Patients with Liver Cirrhosis

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Abstract

Nonalcoholic steatohepatitis is becoming a common cause of liver cirrhosis and a significant number of patients undergoing bariatric surgery suffer with it. There is currently lack of consensus among surgeons regarding safety of bariatric surgery in patients with liver cirrhosis and the best bariatric procedure in these patients. This review investigates published English language scientific literature systematically in an attempt to answer these questions. Eleven studies that reported experience of bariatric surgery in cirrhotic obese patients were included in this review. This review shows an acceptably higher overall risk of complications and perioperative mortality with bariatric surgery in cirrhotic patients. Surgeons must discuss the possibility of an unexpected intraoperative diagnosis of cirrhosis preoperatively with all bariatric surgery patients and agree on a course of action.

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Abbreviations

NAFLD:

Non-alcoholic fatty liver disease

NASH:

Non-alcoholic steatohepatitis

PRISMA:

Preferred reporting items for systematic reviews and meta-analyses

RYGB:

Roux-en-Y gastric bypass

SG:

Sleeve gastrectomy

BPD:

Biliopancreatic diversion

AGB:

Adjustable gastric banding

DS:

Duodenal switch

TIPS:

Transjugular intrahepatic portosystemic shunt

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Conflict of Interest

The authors declare that they have no competing interests.

Author Contribution

KM conceived the idea for the topic and wrote the manuscript. KM and AG independently collected information and analysed it. All authors participated in discussions on the topic. All authors have seen the final version and approve of it.

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Authors and Affiliations

  1. Asian Bariatric Hospital, Ahemdabad, Gujarat, India

    Ahmad Jan & Mahendra Narwaria

  2. Bariatric Unit, Sunderland Royal Hospital, Sunderland, SR4 7TP, UK

    Kamal K. Mahawar

Authors
  1. Ahmad Jan
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  2. Mahendra Narwaria
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  3. Kamal K. Mahawar
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Corresponding author

Correspondence to Kamal K. Mahawar.

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Jan, A., Narwaria, M. & Mahawar, K.K. A Systematic Review of Bariatric Surgery in Patients with Liver Cirrhosis. OBES SURG 25, 1518–1526 (2015). https://doi.org/10.1007/s11695-015-1727-2

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  • DOI: https://doi.org/10.1007/s11695-015-1727-2

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