Sulaiman Almazeedi, MD, Ardeshir Algooneh, Salman Al-Sabah, FRCSC, Maha Ahmed. Amiri Hospital
Non-alcoholic fatty liver disease (NAFLD), a disease highly prevalent among the morbidly obese population, is today one of the most common causes of chronic liver disease. The purpose of this study is to observe the effect of laparoscopic sleeve gastrectomy (LSG) on the resolution of NAFLD.
Methods and Procedures
A retrospective study was conducted of 84 patients diagnosed with NAFLD prior to undergoing LSG. The diagnosis of NAFLD was achieved based on transabdominal ultrasonographic imaging as per the 2012 joint guidelines for the diagnosis of NAFLD (American Gastroenterological Association, American Association for the Study of Liver Diseases, and American College of Gastroenterology). The patients had follow-up anthropometric measurements and were re-evaluated with post-operative ultrasounds at different time frames to assess for the resolution of the disease.
The median age of the patients was 44 (17-62) and 66.7% were female. Average time since surgery was 3.3 years (range 1-5 years). The mean pre and post-operative BMI were 46.6 ±7.8 and 33.0 ±7.1 respectively, with a mean percent excess weight loss (%EWL) of 55.7% ±23.0. A total of 47 (56%) patients showed complete resolution of NAFLD post-operatively. Multivariate analysis showed a significant resolution of NAFLD in patients achieving >50% EWL (OR 10.1; p<0.001) after controlling for age and sex.
Weight loss after LSG effectively resolved NAFLD in more than half of the obese patients in this study, and can prove to be a useful tool in tackling the disease in the future.