The role of bariatric surgery in the management of nonalcoholic steatohepatitis.

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2021-05

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Abstract

Purpose of review

Nonalcoholic fatty liver disease (NAFLD) is the leading cause of chronic liver disease in the United States and increasing globally. The progressive form of NAFLD, nonalcoholic steatohepatitis (NASH), can lead to cirrhosis and complications of end-stage liver disease. No FDA-approved therapy for NAFLD/NASH exists. Treatment of NAFLD/NASH includes effective and sustained life-style modification and weight loss. This review reports on the recent findings of bariatric surgery in the management of NASH.

Recent findings

NAFLD, at all stages, is common in those who meet indication for bariatric surgery. Bariatric surgery resolves NAFLD/NASH and reverses early stages of fibrosis. Although randomized controlled trials of bariatric surgery in NASH are infeasible, studies defining the metabolic changes induced by bariatric surgery, and their effect on NASH, provide insight for plausible pharmacologic targets for the nonsurgical treatment of NASH.

Summary

Resolution of NASH and fibrosis regression can occur after bariatric surgery. Although the exact mechanism(s) underlying the improvement of NASH and hepatic fibrosis following bariatric surgery is not fully elucidated, emerging data on this topic is vitally important for lending insight into the pharmacotherapies for NASH for patients who are not otherwise suitable candidates for bariatric surgery.

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Published Version (Please cite this version)

10.1097/mog.0000000000000721

Publication Info

Seymour, Keri A, and Manal F Abdelmalek (2021). The role of bariatric surgery in the management of nonalcoholic steatohepatitis. Current opinion in gastroenterology, 37(3). pp. 208–215. 10.1097/mog.0000000000000721 Retrieved from https://hdl.handle.net/10161/22502.

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Scholars@Duke

Seymour

Keri Anne Seymour

Associate Professor of Surgery

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