Bariatric surgery’s impact on hepatic cirrhosis: a therapeutic bridge in advanced liver disease

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Hepatic cirrhosis, compounded by obesity, presents a significant clinical challenge, with limited therapeutic options to improve liver function and survival. Bariatric surgery has emerged as a potential intervention, offering metabolic and hepatic benefits. This study evaluates the impact of bariatric surgery on cirrhotic patients, synthesizing evidence from 20 studies using the PRISMA framework. A systematic review was conducted following PRISMA guidelines, identifying 20 studies that assessed the outcomes of bariatric surgery in patients with hepatic cirrhosis. Key outcomes included changes in liver function (MELD and Child-Pugh scores), survival probabilities, weight loss, and post-operative complications. Data were extracted, analyzed, and synthesized to provide a comprehensive evaluation of bariatric surgery's role in this population. Bariatric surgery was associated with significant improvements in liver function, with MELD scores decreasing by an average of 28.6% and Child-Pugh scores transitioning many patients from Class B to Class A. Survival analysis revealed stabilization of survival probabilities at 70% within the first six months and 55-60% at 12 months. Weight loss outcomes were substantial, with an average excess weight loss of 60-70%. Post-operative complications were observed in 20-30% of patients, with the majority occurring within the first six months. Evidence quality, assessed using the GRADE system, was high for liver function and weight loss outcomes but moderate to low for complications. In conclusion, Bariatric surgery offers a promising therapeutic bridge for cirrhotic patients with obesity, improving liver function, survival, and metabolic health. While the findings are encouraging, careful patient selection and perioperative management are critical to optimizing outcomes. Further research is needed to validate these results and explore long-term benefits.