Influencia de la cirugía bariátrica en esteatosis hepática no alcohólica. Evaluación histológica / Influence of bariatric surgery on the non-alcoholic liver steatosis. A histological evaluation

Introducción El hígado graso no alcohólico (HGNA) presenta una alta prevalencia entre los pacientes obesos. Él objetivo de este estudio es conocer la evolución de las lesiones histológicas de estos pacientes a los que se trata mediante derivación biliopancreática. Material y métodos Se intervino de cirugía bariátrica a 76 pacientes obesos en los que se realizó una biopsia hepática. Entre los 12 y 24 meses tras la cirugía se volvió a obtener una nueva biopsia hepática en 39 de ellos. Se analizaron variables clínicas y analíticas en el momento de la intervención y a los 18 meses. Resultados Sesenta y siete pacientes (88,1%) presentaban HGNA en el momento de la intervención. Cuarenta y un pacientes (61,2%) tenían esteatosis simple y 26 pacientes (38,8%) tenían esteatohepatitis no alcohólica (EHNA). Durante el seguimiento se observó una mejoría tanto de la enfermedad asociada como de las evaluaciones analíticas. En la segunda biopsia realizada en 39 pacientes se observó una mejoría importante tanto en el grado de esteatosis como en la EHNA. Ningún paciente mostró empeoramiento de las lesiones .Conclusiones El HGNA presenta una alta prevalencia entre los pacientes obesos. La cirugía bariátrica (Scopinaro) induce una pérdida de peso que se asocia a una mejoría de la enfermedad asociada a la obesidad, así como un descenso significativo de los valores de los parámetros de función hepática. Tras la pérdida de peso, casi la totalidad de estos pacientes presentaron mejoría de las lesiones histológicas hepáticas, y destacó que la EHNA desapareció en el 85% de ellos (AU)

Introduction Non-alcoholic fatty liver (NAFL) is highly prevalent in obese patients. The aim of this study is to look at the development of the histological lesions in these patients that we treated using biliopancreatic diversion. Material and methods A liver biopsy was performed on 76 obese patients who were operated on using bariatric surgery. Another liver biopsy was performed on 39 of them between 12 and 24 months after the surgery. The clinical and analytical variables at the time of the surgery, and at 18 months were analysed. Results A total of 67 patients (88.1%) had NAFL at the time of the operation. Simple steatosis was seen in 41 (61.2%) patients and 26 (38.8%) had non-alcoholic steatohepatitis (NASH). An improvement was seen in both the associated pathology and the analytical evaluations. A significant improvement was observed in the degree of steatosis as well as the NASH in the second biopsy performed on 39 patients. There were no deteriorations in the lesions in any of the patients. Conclusions There is a high prevalence of NAFL among obese patients. Bariatric surgery (Scopinaro) leads to weight loss which is associated to an improvement in the pathology associated with obesity, as well as a significant decrease in the liver function values. After weight loss, almost all our patients showed an improvement in the histological hepatic lesions, and in particular, that NASH disappeared in 85% of them (AU)

[Influence of bariatric surgery on the non-alcoholic liver steatosis. A histological evaluation]. / Influencia de la cirugía bariátrica en esteatosis hepática no alcohólica. Evaluación histológica.

INTRODUCTION: Non-alcoholic fatty liver (NAFL) is highly prevalent in obese patients. The aim of this study is to look at the development of the histological lesions in these patients that we treated using biliopancreatic diversion. MATERIAL AND METHODS: A liver biopsy was performed on 76 obese patients who were operated on using bariatric surgery. Another liver biopsy was performed on 39 of them between 12 and 24 months after the surgery. The clinical and analytical variables at the time of the surgery, and at 18 months were analysed. RESULTS: A total of 67 patients (88.1%) had NAFL at the time of the operation. Simple steatosis was seen in 41 (61.2%) patients and 26 (38.8%) had non-alcoholic steatohepatitis (NASH). An improvement was seen in both the associated pathology and the analytical evaluations. A significant improvement was observed in the degree of steatosis as well as the NASH in the second biopsy performed on 39 patients. There were no deteriorations in the lesions in any of the patients. CONCLUSIONS: There is a high prevalence of NAFL among obese patients. Bariatric surgery (Scopinaro) leads to weight loss which is associated to an improvement in the pathology associated with obesity, as well as a significant decrease in the liver function values. After weight loss, almost all our patients showed an improvement in the histological hepatic lesions, and in particular, that NASH disappeared in 85% of them.

[Prevalence and associated factors to non-alcoholic steatohepatitis in obese patients subjected to bariatric surgery]. / Prevalencia y factores asociados a la esteatohepatitis no alcohólica en pacientes obesos sometidos a cirugía bariátrica.

INTRODUCTION: Non-alcoholic fatty liver disease has a high prevalence among obese patients. It has been difficult to identify clear predictors of chronic liver damage, which could help in selecting patients for liver biopsy and therapeutic options. The aim of the study is to describe the liver damage in these obese patients and identify predictors of liver damage progression. PATIENTS AND METHOD: 76 obese patients submitted to bariatric surgery were included. Liver biopsies were taken at the time at the time of the surgery. Clinical and biochemical variables were analyzed. RESULTS: 67 patients (88.1%) were found to have non-alcoholic fatty liver disease; 41 (61.2%) had simple steatosis, and 26 (38.8%) had non-alcoholic steatohepatitis. Patients with non-alcoholic steatohepatitis had significantly higher values of GGT. Non-alcoholic steatohepatitis was associated with diabetes (p < 0.01) in these patients. CONCLUSIONS: Non-alcoholic fatty liver disease is highly prevalent in morbidly obese patients. Non- alcoholic steatohepatitis seems to be associated with diabetes and high values of GGT in obese patients.

Prevalencia y factores asociados a la esteatohepatitis no alcohólica en pacientes obesos sometidos a cirugía bariátrica / Prevalence and associated factors to nonalcoholic steatohepatitis in obese patients subjected to bariatric surgery

Introducción. El hígado graso no alcohólico presenta una alta prevalencia entre los pacientes obesos. Es difícil identificar variables clínico analíticas predictivas de esteatohepatitis no alcohólica, lo cual podría ayudar a seleccionar a los pacientes que se beneficiarían de biopsia hepática y tratamiento. El objetivo de este estudio es describir las lesiones hepáticas en pacientes obesos e identificar variables que se asocien con parámetros histológicos de progresión. Pacientes y método. Se intervino por cirugía bariátrica a 76 pacientes obesos en los que se realizó biopsia hepática. Se analizaron variables clínicas y analíticas. Resultados. En total, 67 (88,1%) pacientes presentaban hígado graso no alcohólico; 41 (61,2%) (..) (AU)

Introduction. Non-alcoholic fatty liver disease has a high prevalence among obese patients. It has been difficult to identify clear predictors of chronic liver damage, which could help in selecting patients for liver biopsy and therapeutic options. The aim of the study is to describe the liver damage in these obese patients and identify predictors of liver damage progression. Patients and method. 76 obese patients submitted to bariatric surgery were included. Liver biopsies were taken at the time at the time of the surgery. Clinical and biochemical variables were analyzed. Results. 67 patients (88.1%) were found to haven on-alcoholic fatty liver disease; 41 (61.2%) had simple steatosis, and 26 (38.8%) had (..) (AU)

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