Abstract
BackgroundNonalcoholic fatty liver disease (NAFLD) is a common condition in patients with obesity. Bariatric surgery has often been proposed as a viable treatment option, but the ideal surgical procedure remains unclear. Inconsistently, reports on postoperative deterioration of liver function put further doubt on which technique to apply. Aim of this study was to assess the impact of Roux-en-Y-gastric bypass (RYGB) and sleeve gastrectomy (SG) on the postoperative recovery of liver function.MethodsA total of 175 patients with obesity that underwent bariatric surgery in our institution were included in this prospective cohort study. BMI, laboratory values, and liver function capacity (using LiMAx) were assessed preoperatively and at 6 and 12 months postoperatively. Generalized linear model (GLM) was performed to determine variables influencing liver function capacity after the operation.ResultsPrior to operations, 64% of patients presented with a diminished liver function capacity, as measured by LiMAx test. Liver function capacity significantly recovered after 12 months in the SG group (300 μg/kg/h preop vs. 367 μg/kg/h postop) but not in the RYGB group (306 μg/kg/h preop vs. 349 μg/kg/h). Preoperative factors impeding liver function recovery included type 2 diabetes mellitus (T2DM), weight, male sex, AST/thrombocyte ratio (APRI), and gamma-glutamyltransferase (GGT).ConclusionBariatric surgery, especially sleeve gastrectomy, leads to an improvement of liver function. However, in some patients with T2DM, higher preoperative weight and male sex postoperative deterioration of liver function capacity may occur.Graphical abstract
Highlights
Nonalcoholic fatty liver disease (NAFLD) is a progressive condition affecting a large number of patients worldwide, with an estimated prevalence of 25% [1]
There was no statistically significant difference in body mass indices (BMI) prior to operation for patients that underwent sleeve gastrectomy (SG) when compared to patients that underwent Roux-en-Y-gastric bypass (RYGB) (p = 0.87)
Patients in the SG group were more likely to be male (37% vs. 15% in the RYGB group) and suffer from hypertension (63% vs. 51%) and type 2 diabetes mellitus (T2DM) (38% vs. 24%)
Summary
Nonalcoholic fatty liver disease (NAFLD) is a progressive condition affecting a large number of patients worldwide, with an estimated prevalence of 25% [1]. The positive impact of bariatric surgery on altitude of liver enzyme elevation has been assessed in a large prospective intervention study [11]. Nonalcoholic fatty liver disease (NAFLD) is a common condition in patients with obesity. Aim of this study was to assess the impact of Roux-en-Y-gastric bypass (RYGB) and sleeve gastrectomy (SG) on the postoperative recovery of liver function. BMI, laboratory values, and liver function capacity (using LiMAx) were assessed preoperatively and at 6 and 12 months postoperatively. In some patients with T2DM, higher preoperative weight and male sex postoperative deterioration of liver function capacity may occur
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