Non-alcoholic fatty liver disease surgery: Difference between revisions
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==Overview== | ==Overview== | ||
Surgery is not the first-line treatment option for patients with NAFLD. | Surgery is not the first-line treatment option for patients with non- Alcoholic fatty liver disease (NAFLD). However, [[gastric bypass surgery]] is recommended in patients with non-alcoholic fatty liver disease whose [[Body mass index|BMI]] is greater than 40 who psychologically stable and failed medical therapy. | ||
==Surgery== | == 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 surgery|adjustable gastric banding]] and the [[Roux-en-Y|Roux-en-Y bypass]].<ref name="pmid28507929">{{cite journal |vauthors=Vizuete J, Camero A, Malakouti M, Garapati K, Gutierrez J |title=Perspectives on Nonalcoholic Fatty Liver Disease: An Overview of Present and Future Therapies |journal=J Clin Transl Hepatol |volume=5 |issue=1 |pages=67–75 |year=2017 |pmid=28507929 |pmc=5411359 |doi=10.14218/JCTH.2016.00061 |url=}}</ref> | |||
* A Y-shaped section of the [[ileum|i bum]] is attached to the pouch so that [[food]] bypasses the [[duodenum]] and [[Jejunum|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.<ref name="pmid29264490">{{cite journal |vauthors=Boscolo M, Féry F, Cnop M |title=Beneficial Outcomes of Sleeve Gastrectomy in a Morbidly Obese Patient With Bardet-Biedl Syndrome |journal=J Endocr Soc |volume=1 |issue=4 |pages=317–322 |year=2017 |pmid=29264490 |doi=10.1210/js.2017-00071 |url=}}</ref><ref name="pmid25105982">{{cite journal |vauthors=Colquitt JL, Pickett K, Loveman E, Frampton GK |title=Surgery for weight loss in adults |journal=Cochrane Database Syst Rev |volume= |issue=8 |pages=CD003641 |year=2014 |pmid=25105982 |doi=10.1002/14651858.CD003641.pub4 |url=}}</ref> | |||
* The size of the [[stomach]] is reduced either by stapling or [[Banding (medical)|banding]], creating a small pouch, assisting with [[weight loss]] by inducing | |||
** Earlier [[satiety]] | |||
** [[Calorie restriction|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.<ref name="pmid29249127">{{cite journal |vauthors=Germani G, Becchetti C |title=Liver transplantation for non-alcoholic fatty liver disease |journal=Minerva Gastroenterol Dietol |volume= |issue= |pages= |year=2017 |pmid=29249127 |doi=10.23736/S1121-421X.17.02467-9 |url=}}</ref><ref name="pmid28744836">{{cite journal |vauthors=Cholankeril G, Wong RJ, Hu M, Perumpail RB, Yoo ER, Puri P, Younossi ZM, Harrison SA, Ahmed A |title=Liver Transplantation for Nonalcoholic Steatohepatitis in the US: Temporal Trends and Outcomes |journal=Dig. Dis. Sci. |volume=62 |issue=10 |pages=2915–2922 |year=2017 |pmid=28744836 |doi=10.1007/s10620-017-4684-x |url=}}</ref> | |||
** '''Indication 1''' End stage liver-disease | |||
** '''Indication 2''' Hepatocellular carcinoma (HCC) are the two most important indications for the liver transplant. | |||
** '''Outcome :''' After liver transplanation patients with or without NASH may survive 1,3 and 5 years and are increasinly at risk for cardio vascular risks.<ref name="pmid24076414">{{cite journal |vauthors=Wang X, Li J, Riaz DR, Shi G, Liu C, Dai Y |title=Outcomes of liver transplantation for nonalcoholic steatohepatitis: a systematic review and meta-analysis |journal=Clin. Gastroenterol. Hepatol. |volume=12 |issue=3 |pages=394–402.e1 |year=2014 |pmid=24076414 |doi=10.1016/j.cgh.2013.09.023 |url=}}</ref> | |||
==== Complications ==== | |||
* Early complications include: | |||
** [[Peritonitis]] | |||
** [[Pulmonary embolism]] | |||
* Late complications include | |||
** [[Nutritional deficiencies]] | |||
** [[Iron deficiency anemia]] | |||
** [[Dumping syndrome]] | |||
** [[Ulcers]] | |||
==References== | ==References== | ||
Latest revision as of 16:32, 27 December 2017
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Non-Alcoholic Fatty Liver Disease Microchapters |
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Differentiating Non-Alcoholic Fatty Liver Disease from other Diseases |
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Non-alcoholic fatty liver disease surgery On the Web |
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Risk calculators and risk factors for Non-alcoholic fatty liver disease surgery |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Vamsikrishna Gunnam M.B.B.S [2]
Overview
Surgery is not the first-line treatment option for patients with non- Alcoholic fatty liver disease (NAFLD). However, gastric bypass surgery is recommended in patients with non-alcoholic fatty liver disease whose BMI is 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 i bum 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][5]
- Indication 1 End stage liver-disease
- Indication 2 Hepatocellular carcinoma (HCC) are the two most important indications for the liver transplant.
- Outcome : After liver transplanation patients with or without NASH may survive 1,3 and 5 years and are increasinly at risk for cardio vascular risks.[6]
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.
- ↑ Cholankeril G, Wong RJ, Hu M, Perumpail RB, Yoo ER, Puri P, Younossi ZM, Harrison SA, Ahmed A (2017). "Liver Transplantation for Nonalcoholic Steatohepatitis in the US: Temporal Trends and Outcomes". Dig. Dis. Sci. 62 (10): 2915–2922. doi:10.1007/s10620-017-4684-x. PMID 28744836.
- ↑ Wang X, Li J, Riaz DR, Shi G, Liu C, Dai Y (2014). "Outcomes of liver transplantation for nonalcoholic steatohepatitis: a systematic review and meta-analysis". Clin. Gastroenterol. Hepatol. 12 (3): 394–402.e1. doi:10.1016/j.cgh.2013.09.023. PMID 24076414.