Non-alcoholic fatty liver disease surgery
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Vamsikrishna Gunnam M.B.B.S [2]
Overview
Surgical intervention is not recommended for the management of non-alcoholic fatty liver disease. However, gastric bypass surgery is recommended in patients with non-alcoholic fatty liver disease and BMI greater than 40 who psychologically stable and failed medical therapy.
Surgery
Indications
- Patients with NAFLD and BMI greater than 40 who psychologically stable
- In patients who failed medical therapy.
Surgical options
- The most common procedures are adjustable gastric banding and the Roux-en-Y bypass.[1]
- A Y-shaped section of the ileum is attached to the pouch so that food bypasses the duodenum and proximal section of the jejunum.
- A Laparoscopic sleeve gastrectomy may be a secure and powerful treatment of weight problems in adult patients. Significant and sustained weight reduction results in the improvement NAFLD.[2][3]
- The size of the stomach is reduced either by stapling or banding, creating a small pouch, assisting with weight loss by inducing
- Earlier satiety
- Reducing caloric intake
- Decreasing absorptive capacity
- The feasibility of liver transplantation depends on the stage of NAFLD at diagnosis.NAFLD is emerging as the second most common cause for liver transplant.[4]
- Indications : End stage liver-disease and hepatocellular carcinoma (HCC) are the two most important indications for the liver transplant.
Complications
- Early complications include:
- Late complications include
References
- ↑ Vizuete J, Camero A, Malakouti M, Garapati K, Gutierrez J (2017). "Perspectives on Nonalcoholic Fatty Liver Disease: An Overview of Present and Future Therapies". J Clin Transl Hepatol. 5 (1): 67–75. doi:10.14218/JCTH.2016.00061. PMC 5411359. PMID 28507929.
- ↑ Boscolo M, Féry F, Cnop M (2017). "Beneficial Outcomes of Sleeve Gastrectomy in a Morbidly Obese Patient With Bardet-Biedl Syndrome". J Endocr Soc. 1 (4): 317–322. doi:10.1210/js.2017-00071. PMID 29264490.
- ↑ Colquitt JL, Pickett K, Loveman E, Frampton GK (2014). "Surgery for weight loss in adults". Cochrane Database Syst Rev (8): CD003641. doi:10.1002/14651858.CD003641.pub4. PMID 25105982.
- ↑ Germani G, Becchetti C (2017). "Liver transplantation for non-alcoholic fatty liver disease". Minerva Gastroenterol Dietol. doi:10.23736/S1121-421X.17.02467-9. PMID 29249127.