Laparoscopic Sleeve Gastrectomy For The Treatment Of Nonalcoholic Fatty Liver Disease In Patients With Morbid Obesity

Background and purpose: With the rapid increase of the prevalence of obesity worldwide,various complications caused by obesity are also constantly emerging.Obesity causes diabetes,fatty liver disease,high blood pressure and heart disease,but also increases the risk of accidental death.Among the multiple comorbidities of obesity,the incidence of nonalcoholic fatty liver disease occurs almost in parallel with obesity.Non-alcoholic fatty liver disease does not cause enough attention in the early stage of the disease,but non-alcoholic fatty liver disease will lead to serious consequences such as liver cirrhosis and even liver cancer.Studies have shown that laparoscopic sleeve gastrectomy is one of the effective,effective and high safety treatments for obesity.Laparoscopic sleeve gastrectomy(Laparoscopic-assisted sleeve gastrectomy,LSG)is increasingly common in practical practice and has high patient satisfaction.For this reason,we designed the study to observe the improvement of non-alcoholic fatty liver disease(Nonalcoholic fatty liver disease,NAFLD)and the change of various liver function indicators during the follow-up after LSG.Method: The results of 74 patients with LSG treatment were grouped in two modes:(1)divided into two groups according to gender: all female patients treated with LSG in group A;all male patients with LSG treatment in group B;(2)mild,moderate and severe fatty liver: all patients with mild fatty liver treated with LSG in group C;all D patients with moderate fatty liver treated with LSG;all patients with severe fatty liver treated with LSG in group E;small sample size in group D,combined with E and redivided into group F.All patients were in the same group of surgeons and completed the procedure under the same criteria.The main indicators of this study are: body mass index(Body Mass Index,BMI),the improvement of the degree of fatty liver,Biochemical index of hematological liver function(transaminase(glutamate-pyruvate aminotransferase(Alanine aminotransferase,ALT),aspartate aminotransferase(Aspartate aminotransferase,AST)),bilirubin(total bilirubin(Total bilirubin,Tbil),direct bilirubin(Direct bilirubin,Dbil),indirect bilirubin(Indirect bilirubin,IBM)),total cholesterol(Total cholesterol,TC),triglycerides(Triglyceride,TG),total bile acid(Total bile acid,Changes in TBA)).Secondary observation indicators include:improvement of other complications,postoperative complications,postoperative rehabilitation and satisfaction.Results:Different differences in BMI at 1 month between group A and B(P=0.004<0.05),differences in fatty liver severity(P=0.016 <0.05),and higher decreases in ALT and TC in liver function measures in group B than in group A(P <0.05).Male patients improved faster than female patients earlier after surgery,but the gap gradually disappeared at 6 months.In Group C and F,the improvement in TC in Group F was greater than in Group C(P <0.05).From the analysis in Group C,mild fatty liver resolved faster in men than in women at 1 month after surgery(P <0.05).In all the patients,fatty liver remission had a very significant effect(P <0.001)and had a lower incidence of postoperative complications.Conclusion : LSG can effectively treat all degrees of NAFLD and prevent the progression of NAFLD disease.And the safety factor and patient satisfaction have reached a high level.