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- Title
Are Noninvasive Methods Comparable to Liver Biopsy in Postoperative Patients After Roux-en-Y Gastric Bypass?
- Authors
Pereira, Pedro Funari; Von Diemen, Vinicius; Trindade, Eduardo Neubarth; Michalczuk, Matheus Truccolo; Cerski, Carlos Thadeu Schmidt; Mussi, Anderson Correa; Aldabe, Debora Figueiro; Branchi, Raphael Nicola; Knijnik, Pedro Glusman; Brum, Pietro Waltrick; Alvares-da-Silva, Mario Reis; Trindade, Manoel Roberto Maciel
- 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.
- Subjects
LIVER biopsy; GASTRIC bypass; HEPATIC fibrosis; FATTY liver; REGRESSION analysis
- Publication
Obesity Surgery, 2020, Vol 30, Issue 7, p2566
- ISSN
0960-8923
- Publication type
Article
- DOI
10.1007/s11695-020-04513-4