СТЕАТОЗ ПЕЧЕНИ И ЖЕЛЧНОКАМЕННАЯ БОЛЕЗНЬ У БОЛЬНЫХ С МОРБИДНЫМ И СУПЕРОЖИРЕНИЕМ

Abstract

The aim of the study was to estimate the condition of gallbladder, extrahepatic bile ducts and liver in patients with morbid obesity before and after bariatric operations. Materials and methods . 82 patients were operated on for obesity: 39 — for morbid obesity with a body mass index (BMI) of 40–49 and 43 — for super-obesity with a BMI of more than 50. Before and two years after the operation, the condition of the liver and bile ducts was studied based on ultrasound results. Results. 75 patients (91.4%) were diagnosed with metabolic syndrome. The incidence of cholelithiasis in both groups was the same and in general was 32.93%. According to the results of the ultrasound examination in patients with morbid obesity, the utrasonographic fatty liver indicator (US-FLI) ranged from two to six points, with 61.54% of cases diagnosed with mild steatosis, 33.33% — with moderate severity, and 5.13% — with severe steatosis. In patients with superobesity, the US-FLI ranged from six to eight. Moderate steatosis was diagnosed in 41.86%, severe — in 58.14%. Two years later, in group 1, 15 patients (38.36%) had no ultrasound signs of steatosis, and the remaining 24 (61.54%) had mild steatosis. In group 2, mild steatosis was detected in 48.84% of cases, moderate — in 39.53% and severe — in 11.63%. Conclusion. The incidence of gallstone disease in patients with extreme degrees of obesity is 32.93% and does not depend on the body mass index. Correction of liver steatosis is more e ff ective in patients with morbid obesity compared to patients with superobesity. In 11.63% of cases with superobesity and severe steatosis, the liver condition does not improve after bariatric surgery according to ultrasound data.