Therapeutic effects of sleeve gastrectomy for non-alcoholic steatohepatitis estimated by paired liver biopsy in morbidly obese Japanese patients.

Abstract

ABSTRACT:

Bariatric surgery has been reported to improve non-alcoholic steatohepatitis (NASH), which is a frequent comorbidity in morbidly obese patients. We performed a retrospective cohort study to estimate the therapeutic effect of sleeve gastrectomy (SG), the most common bariatric surgery in Japan, on obese patients with NASH by comparing the findings of paired liver biopsies.Eleven patients who underwent laparoscopic SG for the treatment of morbid obesity, defined as body mass index (BMI) > 35 kg/m2, from March 2015 to June 2019 at Hiroshima University Hospital, Japan, were enrolled. All patients were diagnosed with NASH by liver biopsy before or during SG and were re-examined with a second liver biopsy 1 year after SG. The clinical and histological characteristics were retrospectively analyzed.One year after SG, body weight and BMI were significantly reduced, with median reductions in body weight and BMI of-22 kg and -7.9 kg/m2, respectively. Body fat was also significantly reduced at a median of 13.7%. Liver-related enzymes were also significantly improved. On re-examination by paired liver biopsy, liver steatosis improved in 9 of the 11 patients (81.8%), ruling out of the pathological diagnosis of NASH. However, fibrosis stage did not significantly improve 1 year after SG. The non-alcoholic fatty liver disease activity score was significantly reduced in 10 of 11 patients (90.9%).Pathological improvement or remission of NASH could be achieved in most morbidly obese Japanese patients 1 year after SG.

• Authors: Eisuke Murakami, Takashi Nakahara, Akira Hiramatsu, Kei Morio, Hatsue Fujino, Masami Yamauchi, Tomokazu Kawaoka, Masataka Tsuge, Michio Imamura, Hiroshi Aikata, Kenichi Fudeyasu, Yuki Nakashima, Daisuke Iwaki, Daichi Jodai, Toshikazu Ohigashi, Yui Nishimura, Yusuke Minamoto, Akiko Nagao, Masayasu Yoneda, Yoshihiro Saeki, Kazuaki Tanabe, Hideki Ohdan, Kazuaki Chayama
• Journal: Medicine (Medicine (Baltimore)) Vol. 100 Issue 26 Pg. e26436 (Jul 02 2021) ISSN: 1536-5964 [Electronic] United States
• PMID: 34190166 (Publication Type: Journal Article)
• Copyright: Copyright © 2021 the Author(s). Published by Wolters Kluwer Health, Inc.

Topics

• Bariatric Surgery (methods)
• Biopsy (methods)
• Body Mass Index
• Female
• Gastrectomy (methods)
• Humans
• Japan (epidemiology)
• Laparoscopy (methods)
• Liver (pathology)
• Liver Cirrhosis (etiology, pathology)
• Liver Function Tests (methods)
• Male
• Middle Aged
• Non-alcoholic Fatty Liver Disease (blood, etiology, pathology)
• Obesity, Morbid (complications, diagnosis, epidemiology, surgery)
• Remission Induction
• Time