Jaime Ruiz-Tovar1, Maria Engracia Alsina2, Maria Remedios Alpera3. 1. a Department of Surgery, Obesity Unit , General University Hospital Elche , Alicante , Spain. 2. b Department of Radiology, Obesity Unit , General University Hospital Elche , Alicante , Spain. 3. c Obesity Unit , General University Hospital Elche , Alicante , Spain.
Abstract
BACKGROUND: After bariatric surgery an improvement or even complete resolution of nonalcoholic fatty liver disease (NAFLD) in morbidly obese patients is achieved, but little is known about the effect of laparoscopic sleeve gastrectomy (LSG). PATIENTS AND METHODS: A prospective observational study of patients undergoing LSG was performed. An abdominal ultrasonography and blood sample extraction (investigating liver enzymes and lipid profile) were performed preoperatively and 12 months after surgery. RESULTS: Fifty patients were included in the study. Preoperatively, 84% of the patients presented liver steatosis. A significant reduction of steatosis could be observed 12 months after surgery (p < .001). Preoperative degree of steatosis showed a direct correlation with AST (p = .008) and ALT (p = .007) and an inverse correlation with HDL-cholesterol (p = .019). The reduction of liver steatosis showed an inverse correlation with the increase of HDL-cholesterol between pre- and postoperative determinations (p = .008). CONCLUSIONS: Liver steatosis, as measured by ultrasonography, improves after sleeve gastrectomy, achieving a complete resolution in 90% of the cases. Preoperative steatosis correlates directly with AST and ALT levels and inversely with HDL-cholesterol. The postoperative increase of HDL-cholesterol shows an inverse correlation with liver steatosis improvement, suggesting that it could be a good marker for monitoring the postoperative liver status.
BACKGROUND: After bariatric surgery an improvement or even complete resolution of nonalcoholic fatty liver disease (NAFLD) in morbidly obesepatients is achieved, but little is known about the effect of laparoscopic sleeve gastrectomy (LSG). PATIENTS AND METHODS: A prospective observational study of patients undergoing LSG was performed. An abdominal ultrasonography and blood sample extraction (investigating liver enzymes and lipid profile) were performed preoperatively and 12 months after surgery. RESULTS: Fifty patients were included in the study. Preoperatively, 84% of the patients presented liver steatosis. A significant reduction of steatosis could be observed 12 months after surgery (p < .001). Preoperative degree of steatosis showed a direct correlation with AST (p = .008) and ALT (p = .007) and an inverse correlation with HDL-cholesterol (p = .019). The reduction of liver steatosis showed an inverse correlation with the increase of HDL-cholesterol between pre- and postoperative determinations (p = .008). CONCLUSIONS:Liver steatosis, as measured by ultrasonography, improves after sleeve gastrectomy, achieving a complete resolution in 90% of the cases. Preoperative steatosis correlates directly with AST and ALT levels and inversely with HDL-cholesterol. The postoperative increase of HDL-cholesterol shows an inverse correlation with liver steatosis improvement, suggesting that it could be a good marker for monitoring the postoperative liver status.
Authors: Deepa V Cherla; Noe A Rodriguez; Roman Vangoitsenhoven; Tavankit Singh; Neal Mehta; Arthur J McCullough; Stacy A Brethauer; Philip R Schauer; Ali Aminian Journal: Surg Endosc Date: 2019-07-29 Impact factor: 4.584
Authors: Miller Barreto de Brito E Silva; Francisco Tustumi; Antonio Afonso de Miranda Neto; Anna Carolina Batista Dantas; Marco Aurélio Santo; Ivan Cecconello Journal: Obes Surg Date: 2021-04-13 Impact factor: 4.129