論文

査読有り 国際誌
2020年7月

Effects of Laparoscopic Sleeve Gastrectomy on Non-Alcoholic Steatohepatitis and Liver Fibrosis in Japanese Patients with Severe Obesity.

Obesity surgery
  • Haruka Nikai
  • ,
  • Kazuyuki Ishida
  • ,
  • Akira Umemura
  • ,
  • Shigeaki Baba
  • ,
  • Hiroyuki Nitta
  • ,
  • Tamotsu Sugai
  • ,
  • Akira Sasaki

30
7
開始ページ
2579
終了ページ
2587
記述言語
英語
掲載種別
研究論文(学術雑誌)
DOI
10.1007/s11695-020-04515-2

BACKGROUND: The prevalence of non-alcoholic steatohepatitis (NASH) in Japanese patients with severe obesity is extremely high. The aim of the present study was to evaluate the metabolic and histological effects of laparoscopic sleeve gastrectomy (LSG) on NASH and liver fibrosis in Japanese patients with severe obesity. METHODS: Between June 2008 and March 2019, all 79 patients with severe obesity who underwent LSG were included in the study. Sixty-eight patients had an intraoperative liver biopsy performed at the time of LSG. Ultrasound-guided liver biopsies were performed in patients with fibrosis at 12 months after LSG. RESULTS: NASH was present in 43 patients (63.2%), and 10 patients had a unique feature in which their fibrosis were observed without steatosis at the time of LSG. Of the 28 patients with NASH, 25 showed improvement and no longer met the diagnostic criteria of NASH at 12 months after LSG. Mean pericellular fibrosis scores showed significant improvement from 1.62 at baseline, to 1.50, 1.00, and 0.78, respectively (p < 0.001). Univariate analysis of the preoperative predictors in the improvement of fibrosis showed significant effects in preoperative weight (p = 0.037), HbA1c (p = 0.037), and serum insulin (p = 0.037). Multivariate analysis revealed HbA1c to be the only preoperative predictor of improvement in fibrosis (p = 0.004; odds ratio 0.440, 95% CI 0.229-0.842). CONCLUSIONS: LSG has great potential as an effective treatment for patients with NASH.

リンク情報
DOI
https://doi.org/10.1007/s11695-020-04515-2
PubMed
https://www.ncbi.nlm.nih.gov/pubmed/32124215

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