Citation Information :
Yousefi A, Safari F, Pazouki A, Pourzahabi Z, Riazi S, Talebi A. Comparative Study of the Effect of Various Bariatric Surgery Methods on Liver Enzymes and Grading of Nonalcoholic Fatty Liver Based on Ultrasound Scans in Children and Adults. World J Lap Surg 2022; 15 (2):108-115.
Introduction: Bariatric surgery is one of the most effective treatments for patients with morbid obesity. Rapid weight loss can accelerate the process of fibrosis, and weight loss alone can improve the process of steatohepatitis. The conflict has confused the effect of these surgeries on the severity of the fatty liver disease. This retrospective study aimed to compare the effects of different types of bariatric surgery on the grading and severity of the nonalcoholic fatty liver disease (NAFLD).
Materials and methods: Using the National Obesity Surgery Database, data were extracted from 900 patients with a body mass index (BMI) above 35 who underwent sleeve, classic bypass, or mini-bypass surgery or who did not undergo surgery for any reason. Body mass index, aspartate transaminase (AST), alanine transaminase (ALT), NAFLD fibrosis score, and liver ultrasound were evaluated before and after surgery in four different groups.
Results: All three surgical procedures effectively reduced BMI. Among the various surgical procedures, the rate of BMI reduction was significantly higher in the mini-gastric bypass procedure than in the other two methods. The reduction of AST and ALT was significant in all three surgical methods compared to the nonsurgical group, with the highest reduction in sleeve surgery. Fatty liver based on ultrasound in the nonsurgical group in the second time got worse but improved significantly in all the operated groups, and all these changes including the development of fatty liver in the nonsurgical group and its improvement in the operated groups were significant (p <0.05) and NAFLD fibrosis score (NFS) decreased in all groups. This reduction was small and insignificant for the nonsurgical group while it was significant in the three operated groups.
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