Appropriateness of liver biopsy for nonalcoholic fatty liver disease in obese patients during laparoscopic cholecystectomy for gallstone disease

Abstract

Background and aims: Obesity is well known as a risk factor for gallstone disease and is also a risk factor for fatty liver. Before laparoscopic cholecystectomy, it is not easy to detect fatty liver, except for severe fatty liver. Liver biopsy is invasive and is not recommended except in special cases, but is not a relatively risky procedure during laparoscopic cholecystectomy. Therefore, we validated the efficacy of liver biopsy in obese patients during laparoscopic cholecystectomy for gallstone disease. Materials and methods: We retrospectively reviewed medical records in obese patients with gallstone disease who underwent laparoscopic cholecystectomy with liver biopsy. The definition of obesity was based on the Asian obesity criteria. (overweight :23∼24.9, obese class I :>25, & obese class II >30). Total 74 patients were included, and 30 patients were diagnosed as fatty liver (A) and compared with patients without fatty liver disease (B) using various parameters. Results: There were 9 male and 21 female in fatty liver group and 18 male and 26 female without fatty liver. In the fatty liver group, 6 overweight, 19 obese class I, & 5 obese class II, but in the group without fatty liver, 21 overweight, 19 obese class I, & 4 obese class II. The degree of obesity in the fatty liver group was more severe(p=.022). Except level of aminotransferase, all biochemical parameters were not different between two groups. Conclusion: The liver biopsy could be recommended in obese I & II patients with abnormal levels of aminotransferase.