2005 Abstracts: Gastric Reduction Duodenal Switch Operation Has No Detrimental Effects on Hepatic Function and Improves Hepatic Steatosis
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Gastric Reduction Duodenal Switch Operation Has No Detrimental Effects on Hepatic Function and Improves Hepatic Steatosis
Ara Keshishian, Delano surgical Group, Delano, CA
Gastric Reduction Duodenal Switch operation has no detrimental effects on hepatic function and Improves Hepatic Steatosis
Objective: To evaluate the changes in the hepatic function and architecture, after Gastric Reduction Duodenal Switch operation (GR-DS) for treatment of morbid obesity. Background: Nonalcoholic steatohepatitis (NASH) is the most common histological finding in morbidly obese patients undergoing liver biopsy. Biliopancreatic diversion has been used for the treatment of morbid obesity and hepatic steatosis, and very few cases of liver impairment as a complication of this operation have been reported. Our experience with GR-DS operation demonstrates improvement in liver Steatosis, without any evidence of hepatic dysfunction. Methods: We have to date (1999-2004) performed 732 GR-DS operations for treatment of morbid obesity. As per previously published literature and our protocol, routine liver Tru-Cut needle biopsy is performed during the GR-DS surgery. Liver function tests (LFT's) are assayed pre-operatively as well post-operatively at 6, 12, and 18 months and yearly thereafter. Repeat Tru-Cut biopsy of the liver is performed on all the patients who underwent a second intra-abdominal surgery for any indication (n=82). To obtain blinding, the pathologist evaluated the two sets of liver biopsies independently, without comparison between the two. In particular the adipose tissue content and the degree of hepatitis were compared in these patients. Results:| ALT-Pre | ALT-6M | ALT-12M | ALT-24M | ALT-36M | ALT-48M | |
| Median | 26 | 31 | 26 | 27 | 27 | 19 |
| STDEV | 19.6 | 23.3 | 16.8 | 17.3 | 21 | 12.9 |
| AST-Ppre | AST-6M | AST-12M | AST-24M | AST-36M | AST-48M | |
| Median | 22 | 24 | 21 | 22 | 23 | 18 |
| STDEV | 13.7 | 13.6 | 14.7 | 14 | 18.7 | 9.6 |
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