Background. Gastric-capacity-reducing procedures which limit food intake, are the current surgical approaches to morbid obesity. Intestinal bypass procedures have been set aside because believed to cause severe liver damage, however remain a valid alternative in highly selected cases when gastroplasties are not feasible or refused by bulimic patients, or for other several reasons. Methods. To verify if these procedures really cause liver damage, the clinical data of 78 morbidly obese patients submitted to intestinal bypass surgery, between 1976 and 1990, were assessed. In 70 cases, a routine liver biopsy had been taken at surgery. When, in 9 cases, after some years, the bypass was converted, a further liver biopsy was obtained for comparison with the pre-bypass status. Results. The histopathological results showed that 100% of the patients submitted to bypass bariatric procedures had liver alterations at surgery (various stages of steatosis were detected in 84% of the cases, while in others portal phlogosis, portal fibrosis, necrosis and even cirrhosis were found). Among the 9 cases reconverted, the liver changes had progressed in 3, remained stable in 4 and markedly improved in 2. Conclusions. Intestinal bypass bariatric surgery still finds a place as an alternative to gastric capacity reducing procedures, since the progression of liver damage is not really correlated to the new condition.
|Translated title of the contribution||Intestinal bypass and liver pathology in morbid obesity|
|Number of pages||4|
|Publication status||Published - 1998|
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