BACKGROUND: Nonalcoholic fatty liver disease (NAFLD) has been increasingly recognized as a common chronic liver condition. Previous studies have been variable regarding the histological outcomes after rapid weight loss. The aim of this study was to characterize the histopathologic changes in NASH following laparoscopic Roux-en-Y Gastric Bypass surgery (LRYGBP). METHODS: We retrospectively analyzed paired needle liver biopsies taken during and following LRYGBP in 39 patients according to the recent NIH-based NAFLD criteria. RESULTS: The cohort included 33 females and 6 males (range 24-57 years). 23 patients (58.9%) had steatohepatitis, 12 with fatty liver (30.7%), and 4 were normal (10.2%). Follow-up needle liver biopsies were performed at a mean interval of 18 months (range 6-41 months). No significant differences in length or number of portal tracts between the paired biopsies were noted. The mean decrease in weight and BMI was 50.2 kg and 18.2 kg/m2, respectively. The initial prevalence of hepatic pathology: steatosis (89.7%), hepatocellular ballooning (58.9%), and centrilobular/perisinusoidal fibrosis (50%) improved significantly after LRYGBP: steatosis (2.9%), ballooning (0%), and centrilobular fibrosis (25%). Mitigation in the lobular inflammation score (2.23+/-0.63 vs 1.95+/-0.56, P=0.01) and stage of fibrosis (1.14+/-1.05 to 0.72+/-0.97, P=0.002) were also noted. However, no improvements were detected in portal tract inflammation and fibrosis. CONCLUSIONS: Over a mean period of 18 months, histological improvements and resolution of NASH occurs after LRYGBP. Long-term studies are warranted to assess for potential changes in the portal regions or relapse of NASH that could result with weight regain or malnutrition.
BACKGROUND:Nonalcoholic fatty liver disease (NAFLD) has been increasingly recognized as a common chronic liver condition. Previous studies have been variable regarding the histological outcomes after rapid weight loss. The aim of this study was to characterize the histopathologic changes in NASH following laparoscopic Roux-en-Y Gastric Bypass surgery (LRYGBP). METHODS: We retrospectively analyzed paired needle liver biopsies taken during and following LRYGBP in 39 patients according to the recent NIH-based NAFLD criteria. RESULTS: The cohort included 33 females and 6 males (range 24-57 years). 23 patients (58.9%) had steatohepatitis, 12 with fatty liver (30.7%), and 4 were normal (10.2%). Follow-up needle liver biopsies were performed at a mean interval of 18 months (range 6-41 months). No significant differences in length or number of portal tracts between the paired biopsies were noted. The mean decrease in weight and BMI was 50.2 kg and 18.2 kg/m2, respectively. The initial prevalence of hepatic pathology: steatosis (89.7%), hepatocellular ballooning (58.9%), and centrilobular/perisinusoidal fibrosis (50%) improved significantly after LRYGBP: steatosis (2.9%), ballooning (0%), and centrilobular fibrosis (25%). Mitigation in the lobular inflammation score (2.23+/-0.63 vs 1.95+/-0.56, P=0.01) and stage of fibrosis (1.14+/-1.05 to 0.72+/-0.97, P=0.002) were also noted. However, no improvements were detected in portal tract inflammation and fibrosis. CONCLUSIONS: Over a mean period of 18 months, histological improvements and resolution of NASH occurs after LRYGBP. Long-term studies are warranted to assess for potential changes in the portal regions or relapse of NASH that could result with weight regain or malnutrition.
Authors: Samuel Klein; Bettina Mittendorfer; J Christopher Eagon; Bruce Patterson; Lafaine Grant; Nikki Feirt; Ekihiro Seki; David Brenner; Kevin Korenblat; Jennifer McCrea Journal: Gastroenterology Date: 2006-05 Impact factor: 22.682
Authors: Kevin B Barker; Nicole A Palekar; Steven P Bowers; Joel E Goldberg; Joseph P Pulcini; Stephen A Harrison Journal: Am J Gastroenterol Date: 2006-02 Impact factor: 10.864
Authors: Soraya Rodrigues de Almeida; Paulo Roberto Savassi Rocha; Marcelo Dias Sanches; Virgínia Hora Rios Leite; Rogério Augusto Pinto da Silva; Marco Túlio Costa Diniz; Maria de Fátima Haueisen Sander Diniz; Alexandre Lages Savassi Rocha Journal: Obes Surg Date: 2006-03 Impact factor: 4.129
Authors: Melissa A Linden; Ryan D Sheldon; Grace M Meers; Laura C Ortinau; E Matthew Morris; Frank W Booth; Jill A Kanaley; Victoria J Vieira-Potter; James R Sowers; Jamal A Ibdah; John P Thyfault; M Harold Laughlin; R Scott Rector Journal: J Physiol Date: 2016-05-27 Impact factor: 5.182
Authors: Amit D Tevar; Calissia Clarke; Jiang Wang; Steven M Rudich; E Steve Woodle; Alex B Lentsch; Michael L Edwards Journal: J Am Coll Surg Date: 2010-04 Impact factor: 6.113