Impact of a preoperative low-calorie diet on liver histology in patients with fatty liver disease undergoing bariatric surgery.
Bariatric surgery
Liver histology
Low-calorie diet
Nonalcoholic steatohepatitis
Preoperative weight loss
Journal
Surgery for obesity and related diseases : official journal of the American Society for Bariatric Surgery
ISSN: 1878-7533
Titre abrégé: Surg Obes Relat Dis
Pays: United States
ID NLM: 101233161
Informations de publication
Date de publication:
Oct 2019
Oct 2019
Historique:
received:
14
05
2019
revised:
22
07
2019
accepted:
13
08
2019
pubmed:
29
9
2019
medline:
1
9
2020
entrez:
28
9
2019
Statut:
ppublish
Résumé
A low-calorie diet (LCD) before bariatric surgery has been shown to reduce liver volume and facilitate ease of operation. It is estimated that 75%-100% of individuals undergoing bariatric surgery have nonalcoholic fatty liver disease (NAFLD). We aimed to investigate how an LCD affects liver histology in the setting of NAFLD. University Hospital, United States. Forty intraoperative liver specimens were analyzed histologically as follows: 20 with and 20 without a preoperative 2-week, 1200 kcal/d LCD. Weight was measured prediet, at surgery, and 6 months after surgery. NAFLD activity score was used to grade liver histology at surgery. The NAFLD activity score scores steatosis, lobular inflammation, hepatocellular ballooning, and fibrosis. The non-LCD group (n = 20) had mean weight at surgery of 136.1 ± 24.1 kg. The LCD group (n = 20) had initial mean weight of 128.6 ± 25.4 kg, with presurgical weight loss of 3.43 kg (range, 0-9.3 kg), mean change in body mass index 1.24 kg/m A 2-week LCD before bariatric surgery is associated with significant improvement in steatosis, inflammation, and hepatocellular ballooning in NAFLD. Among LCD patients, preoperative weight loss was associated with improved 6-month weight loss and liver function.
Sections du résumé
BACKGROUND
BACKGROUND
A low-calorie diet (LCD) before bariatric surgery has been shown to reduce liver volume and facilitate ease of operation. It is estimated that 75%-100% of individuals undergoing bariatric surgery have nonalcoholic fatty liver disease (NAFLD).
OBJECTIVES
OBJECTIVE
We aimed to investigate how an LCD affects liver histology in the setting of NAFLD.
SETTING
METHODS
University Hospital, United States.
METHODS
METHODS
Forty intraoperative liver specimens were analyzed histologically as follows: 20 with and 20 without a preoperative 2-week, 1200 kcal/d LCD. Weight was measured prediet, at surgery, and 6 months after surgery. NAFLD activity score was used to grade liver histology at surgery. The NAFLD activity score scores steatosis, lobular inflammation, hepatocellular ballooning, and fibrosis.
RESULTS
RESULTS
The non-LCD group (n = 20) had mean weight at surgery of 136.1 ± 24.1 kg. The LCD group (n = 20) had initial mean weight of 128.6 ± 25.4 kg, with presurgical weight loss of 3.43 kg (range, 0-9.3 kg), mean change in body mass index 1.24 kg/m
CONCLUSIONS
CONCLUSIONS
A 2-week LCD before bariatric surgery is associated with significant improvement in steatosis, inflammation, and hepatocellular ballooning in NAFLD. Among LCD patients, preoperative weight loss was associated with improved 6-month weight loss and liver function.
Identifiants
pubmed: 31558407
pii: S1550-7289(19)30380-6
doi: 10.1016/j.soard.2019.08.013
pii:
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
1766-1772Commentaires et corrections
Type : CommentIn
Type : CommentIn
Informations de copyright
Copyright © 2019 American Society for Bariatric Surgery. Published by Elsevier Inc. All rights reserved.