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02.03.2020 | Original Contributions | Ausgabe 7/2020

Obesity Surgery 7/2020

Are Noninvasive Methods Comparable to Liver Biopsy in Postoperative Patients After Roux-en-Y Gastric Bypass?

Zeitschrift:
Obesity Surgery > Ausgabe 7/2020
Autoren:
Pedro Funari Pereira, Vinicius Von Diemen, Eduardo Neubarth Trindade, Matheus Truccolo Michalczuk, Carlos Thadeu Schmidt Cerski, Anderson Correa Mussi, Debora Figueiro Aldabe, Raphael Nicola Branchi, Pedro Glusman Knijnik, Pietro Waltrick Brum, Mario Reis Alvares-da-Silva, Manoel Roberto Maciel Trindade
Wichtige Hinweise

Electronic supplementary material

The online version of this article (https://​doi.​org/​10.​1007/​s11695-020-04513-4) contains supplementary material, which is available to authorized users.

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Abstract

Introduction

Transient tissue elastography (TTE) may estimate the degree of hepatic fibrosis in patients with obesity, but the method has restrictions that are mainly related to patients’ BMI.

Purpose

To compare the results of the evaluation of hepatic fibrosis by biochemical methods and TTE with those determined by liver biopsy in patients after RYGB.

Methods

This was a cross-sectional study involving patient data, TTE, and liver biopsy 1 year after RYGB.

Results

Of the 94 selected patients, 33 underwent TTE and liver biopsy. The average weight of patients was 84.4 ± 15.4 kg. The mean APRI was 0.2 ± 0.1, and 36 patients (97.3%) were classified as F0–F1. The average NFS was − 2.0 ± 1.0, with 25 patients (67%) classified as F0–F1 and 12 patients (32.4%) classified as F2. The agreement rate between Fibroscan and liver biopsy was 80.0%. Histological analysis revealed regression of inflammatory changes in all patients: 26 patients (72.2%) had some degree of non-alcoholic steatohepatitis (NAS ≥ 5), and after surgery, no patient presented inflammation upon biopsy. Nine patients (24.3%) had fibrosis at surgery, and only two (5.4%) still had fibrosis 1 year later (p < 0.008).

Conclusions

The use of APRI and Fibroscan is promising, but more studies are needed to evaluate patients with an advanced degree of NAFLD and confirm the entire spectrum of the disease.

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