Current Controversies in Metabolic Surgery for Nonalcoholic Fatty Liver Disease

Obes Surg. 2019 Mar;29(3):1058-1067. doi: 10.1007/s11695-019-03705-x.

Abstract

Nonalcoholic fatty liver disease (NAFLD) represents the most common liver disease, and it is expected to become the leading cause of end-stage liver disease in the near future. Bariatric operations have beneficial effects on NAFLD, inducing histological resolution of liver damage through weight loss-dependent and weight loss-independent mechanisms. Due to lack of randomized controlled trials, no specific guidelines have been established so far. Yet there is growing evidence that NAFLD will eventually become a formal indication for metabolic surgery. Data regarding the choice of procedure are conflicting, although gastric bypass seems to be slightly superior to sleeve gastrectomy. The purpose of this review is to provide an update on the ongoing research regarding the role of metabolic surgery in NAFLD management.

Keywords: Bariatric surgery; Gastric bypass; Liver steatosis; Metabolic surgery; Nonalcoholic fatty liver disease; Sleeve gastrectomy; Steatohepatitis.

Publication types

  • Review

MeSH terms

  • Bariatric Surgery* / methods
  • Bariatric Surgery* / psychology
  • Bariatric Surgery* / standards
  • Bariatric Surgery* / statistics & numerical data
  • End Stage Liver Disease / epidemiology
  • End Stage Liver Disease / prevention & control
  • Gastrectomy / adverse effects
  • Gastrectomy / methods
  • Gastrectomy / psychology
  • Gastrectomy / statistics & numerical data
  • Gastric Bypass / adverse effects
  • Gastric Bypass / methods
  • Gastric Bypass / psychology
  • Gastric Bypass / statistics & numerical data
  • Humans
  • Non-alcoholic Fatty Liver Disease / complications
  • Non-alcoholic Fatty Liver Disease / epidemiology
  • Non-alcoholic Fatty Liver Disease / surgery*
  • Obesity, Morbid / complications
  • Obesity, Morbid / epidemiology
  • Obesity, Morbid / surgery
  • Treatment Outcome