Basics of Bariatric Surgery

Bariatric surgery helps patients lose substantial weight, through a simple surgical procedure. This part we have all heard of. What many don’t know is that it can also result in a positive improvement of non-alcoholic fatty liver disease (NAFLD), according to new research presented in the Digestive Disease Week (DDW). Researchers at the University of South Florida-Tampa found that bariatric surgery seemed to resolve liver inflammation and even reversed early-stage liver fibrosis – the thickening and scarring of liver tissue – by reducing fat deposits in the liver.

“About 30 percent of the U.S. population suffers from this disease, and more than half of this group is under the category of severely obese,” said Michel Murr, MD, lead researcher of the study, professor of surgery and director of Tampa General Hospital and USF Health Bariatric Center. “Our findings suggest that providers should consider bariatric surgery as a treatment of choice for non-alcoholic fatty liver disease in severely obese patients.”

Dr. Murr and his team suggest that bariatric surgery be considered for patients with a higher body mass index (BMI), greater than 35. He believes that obesity-related co-morbidities may not get completely treated with traditional interventions, such as medications.

Researchers compared liver biopsies from 152 patients taken during the time of the bariatric procedure and then again after 29 months. In examining the first set of biopsies, researchers found that the patients had a higher probability of non-alcoholic fatty liver disease. This type of liver damage can lead to life-threatening conditions such as liver fibrosis and cirrhosis.

After reviewing post-operative biopsies, they found that bariatric surgery resulted in improvements in these patients. Fat deposits on the liver had resolved in 70 percent of patients. Inflammation was also improved, with lobular inflammation resolved in 74 percent of patients, chronic portal inflammation resolved in 32 percent, and steatohepatitis resolved in 88 percent.

In addition to these improvements, 62 percent of patients with stage-2 liver fibrosis showed an improvement in the degree of fibrosis. One of three patients with cirrhosis also showed improvement. Dr. Murr noted that these findings apply only to early-stage fibrosis, and not late-stage liver disease.

“We are in the midst of an obesity epidemic that can lead to an epidemic of non-alcoholic fatty liver disease,” said Dr. Murr. “As a tool in fighting obesity, bariatric surgery could also help prevent the emergence of widespread liver disease.”