Duodenal Switch Has No Detrimental Effects on Hepatic Function and Improves Hepatic Steatohepatitis after 6 Months (original) (raw)

Background: Nonalcoholic steatohepatitis (NASH) is a common histological finding on liver biopsy in morbidly obese patients. The condition, although benign, can progress to cirrhosis and liver failure. We investigated the effect of the duodenal switch (DS) operation on hepatic function and architecture, specifically hepatic steatosis and NASH. Methods: Between November 1999 and June 2004, 697 DS operations were performed for the treatment of morbid obesity. A Tru-Cut needle liver biopsy was routinely performed during the DS operation. Liver function tests were drawn preoperatively for AST and ALT, and again postoperatively at 6, 12 and 18 months and yearly thereafter. Repeat Tru-Cut liver biopsy was performed on all patients (n = 78) who underwent a second intra-abdominal operation for any indication ≥6 months postoperatively. The pathologist evaluated the 2 sets of liver biopsies in a blinded fashion. The hepatic adipose tissue content and the degree of hepatitis were compared in these patients. Results: A transient worsening of the AST (13% of the baseline value, P<.02) and ALT ( 130-160% of the baseline value, P<.0001) levels was found at 6 months after the DS operation. Normal levels were achieved by 12 months postoperatively. A progressive improvement of about 3 grades in severity of NASH and a 60% improvement in hepatic steatosis, were seen by 3 years after the DS operation. Conclusion: DS improves both hepatic steatosis and its resulting inflammation. No detrimental effects on hepatic function were noted after 6 months.

Access this article

Log in via an institution

Subscribe and save

Buy Now

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

Author information

Authors and Affiliations

  1. Department of Surgery, Delano Regional Medical Center, Delano, CA, USA
    Ara Keshishian MD, FACS
  2. Department of Surgery, Delano Regional Medical Center, Delano, CA, USA
    Karim Zahriya MD, FACS
  3. Chief Department of Pathology, Delano Regional Medical Center, Delano, CA, USA
    Edric B Willes MD

Authors

  1. Ara Keshishian MD, FACS
  2. Karim Zahriya MD, FACS
  3. Edric B Willes MD

Rights and permissions

About this article

Cite this article

Keshishian, A., Zahriya, K. & Willes, E.B. Duodenal Switch Has No Detrimental Effects on Hepatic Function and Improves Hepatic Steatohepatitis after 6 Months.OBES SURG 15, 1418–1423 (2005). https://doi.org/10.1381/096089205774859290

Download citation