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Abstract Details
Bariatric Surgery in NAFLD
Dig Dis Sci. 2022 Feb;67(2):408-422. doi: 10.1007/s10620-021-07317-3.Epub 2022 Jan 4.
Mahak Chauhan1, Kuldeep Singh1, Paul J Thuluvath23
Author information
Institute of Digestive Health and Liver Diseases, Mercy Medical Center, Baltimore, MD, USA.
Institute of Digestive Health and Liver Diseases, Mercy Medical Center, Baltimore, MD, USA. thuluvath@gmail.com.
Department of Medicine, University of Maryland School of Medicine, Baltimore, MD, USA. thuluvath@gmail.com.
Abstract
Currently, there are no approved medications to treat patients with nonalcoholic steatohepatitis (NASH) with fibrosis or cirrhosis. Although the management goal in these patients is weight reduction by 7-10% with lifestyle modifications, only less than 10% of patients achieve this target at 1-year, and fewer maintain the weight loss at 5 years. Bariatric surgery is an option that may be considered in those who fail to lose weight by lifestyle changes. Bariatric surgery has been shown to improve liver histology including fibrosis secondary to NASH, in addition to other benefits including an improvement or resolution of type 2 diabetes mellitus, dyslipidemia, and hypertension, and a reduction of cardiovascular morbidity or mortality. There are no guidelines of bariatric surgery indications for the management of NASH. The purpose of this review is to critically appraise the current knowledge of the role of bariatric surgery and the potential mechanisms for its perceived benefits in the management of patients with NASH-related liver disease.