Risks and Rewards of Bariatric Surgery in Advanced Chronic Liver Diseases.
Semin Liver Dis
; 41(4): 448-460, 2021 11.
Article
em En
| MEDLINE
| ID: mdl-34243194
ABSTRACT
The burden of obesity and metabolic syndrome has determined a sharp increase in bariatric surgery (BS) procedures, which lead to marked weight loss, improved metabolic syndrome, reduced cardiovascular risk, and even improvement in nonalcoholic steatohepatitis (NASH). Despite these promising results, BS in patients with chronic liver disease can rarely lead to worsening of liver function, progression to cirrhosis and its complications, and even liver transplantation. On the other hand, since obesity in patients with cirrhosis is a major cofactor for progression to a decompensated stage of the disease and a risk factor for hepatocellular carcinoma, BS has been used to achieve weight loss in this population. In this review, we critically analyze the existing data on outcomes of BS in patients with cirrhosis and the possible mechanisms leading to fibrosis progression and worsening liver function in patients undergoing BS. Finally, we propose a set of measures that could be taken to improve the multidisciplinary management of liver disease in patients undergoing BS, including early recognition of malnutrition and alcohol misuse.
Texto completo:
1
Bases de dados:
MEDLINE
Assunto principal:
Cirurgia Bariátrica
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Hepatopatia Gordurosa não Alcoólica
/
Neoplasias Hepáticas
Tipo de estudo:
Diagnostic_studies
/
Etiology_studies
/
Risk_factors_studies
Limite:
Humans
Idioma:
En
Revista:
Semin Liver Dis
Ano de publicação:
2021
Tipo de documento:
Article
País de afiliação:
Suíça