Ming-Lun Han1,2, Wei-Jei Lee3,4, Jung-Chien Chen3, Kong-Han Ser3, Shu-Chun Chen3, Yi-Chih Lee5. 1. Department of Internal Medicine, Ming-Sheng General Hospital, National Taiwan University, Taipei, Taiwan. 2. Department of Integrated Diagnostics & Therapeutics, National Taiwan University Hospital, Taipei, Taiwan. 3. Department of Surgery, Ming-Sheng General Hospital, National Taiwan University, Taipei, Taiwan. 4. , Tauoyan, Republic of China. 5. Department of International Business, Chien Hsin University of Science and Technology, Taoyuan, Taiwan.
Abstract
BACKGROUND: Hepatitis C virus (HCV) is an important cause of liver cirrhosis and its complications. The safety and efficacy of bariatric surgery in patients with HCV infection is not clear. METHODS: Charts were reviewed to identify patients with HCV infection before bariatric surgery. Bariatric surgical patients with non-alcoholic steatohepatitis (NASH) and without NASH (non-NASH) were recruited as comparative groups. Demographic variables, perioperative data, follow-up, and HCV-related parameters were extracted and compared. RESULTS: Forty-seven bariatric patients between 2000 and 2016 that suffered from HCV infection were identified. The mean age and body mass index (BMI) at baseline were 34.5 ± 9.9 years and 40.4 ± 7.7 kg/m2, respectively. The HCV(+) group was associated with female sex, older age, lower BMI, and waist circumference than both NASH and non-NASH groups. Both HCV(+) and NASH groups had higher liver function tests and incidence of metabolic syndrome than non-NASH group. The HCV(+) group had lower uric acid and albumin level than the NASH group. Early major postoperative complication occurred in 1 (2.1%) patient of the HCV(+) group. At follow-up, the mean BMI decreased to 29.1 ± 7.1 kg/m2 and total weight loss was 25% for the HCV(+) group at 5 years after surgery. The weight loss curves were similar between the HCV(+) group and NASH group. During follow-up, no patients died but one patient with HCV(+) developed flare up of hepatitis after gastric bypass. The mean liver transaminase level remained in normal range for the HCV(+) group. CONCLUSION: Co-existence of HCV infection does not influence the outcome of bariatric surgery but continued monitoring of the liver function is indicated.
BACKGROUND:Hepatitis C virus (HCV) is an important cause of liver cirrhosis and its complications. The safety and efficacy of bariatric surgery in patients with HCV infection is not clear. METHODS: Charts were reviewed to identify patients with HCV infection before bariatric surgery. Bariatric surgical patients with non-alcoholic steatohepatitis (NASH) and without NASH (non-NASH) were recruited as comparative groups. Demographic variables, perioperative data, follow-up, and HCV-related parameters were extracted and compared. RESULTS: Forty-seven bariatric patients between 2000 and 2016 that suffered from HCV infection were identified. The mean age and body mass index (BMI) at baseline were 34.5 ± 9.9 years and 40.4 ± 7.7 kg/m2, respectively. The HCV(+) group was associated with female sex, older age, lower BMI, and waist circumference than both NASH and non-NASH groups. Both HCV(+) and NASH groups had higher liver function tests and incidence of metabolic syndrome than non-NASH group. The HCV(+) group had lower uric acid and albumin level than the NASH group. Early major postoperative complication occurred in 1 (2.1%) patient of the HCV(+) group. At follow-up, the mean BMI decreased to 29.1 ± 7.1 kg/m2 and total weight loss was 25% for the HCV(+) group at 5 years after surgery. The weight loss curves were similar between the HCV(+) group and NASH group. During follow-up, no patientsdied but one patient with HCV(+) developed flare up of hepatitis after gastric bypass. The mean liver transaminase level remained in normal range for the HCV(+) group. CONCLUSION: Co-existence of HCV infection does not influence the outcome of bariatric surgery but continued monitoring of the liver function is indicated.
Entities:
Keywords:
Bariatric surgery; HCV infection; Liver transaminase; Weight loss