Bariatric surgery’s impact on hepatic cirrhosis: a therapeutic bridge in advanced liver disease




Research Article                

American Journal of BioMedicine                  

Volume 12, Issue 4, 2024, Pages 117- 137    10.18081/2333-5106/2024.12/117

Yong Lee , Pavlos Jonthan , Winnie Chen, Catharina Grulich 1*

Author Affiliations
1 Department of Medicine research, Heidelberg University, Germany.

Received 31 July 2024; revised 01 September 2024; accepted 21 September 2024; published 04 November 2024

Abstract

Hepatic cirrhosis, compounded by obesity, presents a significant clinical challenge, with limited therapeutic options to improve liver function and survival. Bariatric surgery has emerged as a potential intervention, offering metabolic and hepatic benefits. This study evaluates the impact of bariatric surgery on cirrhotic patients, synthesizing evidence from 20 studies using the PRISMA framework. A systematic review was conducted following PRISMA guidelines, identifying 20 studies that assessed the outcomes of bariatric surgery in patients with hepatic cirrhosis. Key outcomes included changes in liver function (MELD and Child-Pugh scores), survival probabilities, weight loss, and post-operative complications. Data were extracted, analyzed, and synthesized to provide a comprehensive evaluation of bariatric surgery's role in this population. Bariatric surgery was associated with significant improvements in liver function, with MELD scores decreasing by an average of 28.6% and Child-Pugh scores transitioning many patients from Class B to Class A. Survival analysis revealed stabilization of survival probabilities at 70% within the first six months and 55-60% at 12 months. Weight loss outcomes were substantial, with an average excess weight loss of 60-70%. Post-operative complications were observed in 20-30% of patients, with the majority occurring within the first six months. Evidence quality, assessed using the GRADE system, was high for liver function and weight loss outcomes but moderate to low for complications. In conclusion, Bariatric surgery offers a promising therapeutic bridge for cirrhotic patients with obesity, improving liver function, survival, and metabolic health. While the findings are encouraging, careful patient selection and perioperative management are critical to optimizing outcomes. Further research is needed to validate these results and explore long-term benefits.

Keywords: Bariatric Surgery, Hepatic Cirrhosis, Advanced Liver Disease, Portal Hypertension

Copyright © 2024 Feng, et al. This article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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Lee Y, Jonthan P, Grulich C. Bariatric surgery's impact on hepatic cirrhosis: a therapeutic bridge in advanced liver disease. American Journal of BioMedicine 2024; 12(4):117-137.

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Lee Y, Jonthan P, Grulich C (2024). Bariatric surgery's impact on hepatic cirrhosis: a therapeutic bridge in advanced liver disease. American Journal of Biomedicine, 12(4), 117-137. https://doi.org/ 10.18081/2333-5106/2024.12/117
Lee Y, Jonthan P, Grulich C. "Bariatric surgery's impact on hepatic cirrhosis: a therapeutic bridge in advanced liver disease." American Journal of Biomedicine, vol. 12, no. 4, 2024, pp. 117-137. DOI: 10.18081/2333-5106/2024.12/117.
Lee Y, Jonthan P, Grulich C. Bariatric surgery's impact on hepatic cirrhosis: a therapeutic bridge in advanced liver disease. Am J Biomed. 2024;12(4):117-137. DOI: 10.18081/2333-5106/2024.12/117. PMID: .
Lee Y, Jonthan P, Grulich C 2024, "Bariatric surgery's impact on hepatic cirrhosis: a therapeutic bridge in advanced liver disease", American Journal of Biomedicine, vol. 12, no. 4, pp. 117-137.
@article{lee2024, title={Bariatric surgery's impact on hepatic cirrhosis: a therapeutic bridge in advanced liver disease}, author={Lee Y, Jonthan P, Grulich C}, journal={American Journal of Biomedicine}, volume={12}, number={4}, pages={117-137}, year={2024}, doi={ 10.18081/2333-5106/2024.12/117} }
TY - JOUR AU - Lee Y, Jonthan P, Grulich C TI - Bariatric surgery's impact on hepatic cirrhosis: a therapeutic bridge in advanced liver disease JO - American Journal of Biomedicine VL - 12 IS - 4 SP - 117-137 PY - 2024 DO - 10.18081/2333-5106/2024.12/117 ER -
%0 Journal Article %A Lee Y, Jonthan P, Grulich C %T Bariatric surgery's impact on hepatic cirrhosis: a therapeutic bridge in advanced liver disease %J American Journal of Biomedicine %V 12 %N 4 %P 117-137 %D 2024 %R 10.18081/2333-5106/2024.12/117 %M
Lee Y, Jonthan P, Grulich C (2024). Bariatric surgery's impact on hepatic cirrhosis: a therapeutic bridge in advanced liver disease. American Journal of Biomedicine, 12(4), 117-137. https://doi.org/ 10.18081/2333-5106/2024.12/117

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