Endocrine Abstracts

Introduction

Obesity is an undeniable global health problem that has taken on epidemic proportions in both developed and developing countries. Bariatric surgery offers a promising therapeutic option mostly in the face of frequent failures of dietary management of obesity. Our study aimed to describe the evolution of parameters of liver function after sleeve gastrectomy.

Methods

It was a retrospective study including 40 obese patients who were followed up at the Research Unit on Obesity at the National Institute of Nutrition and Food Technology in Tunis up to 12 months after sleeve gastrectomy. In preoperative, all patients underwent an abdominal ultrasound and a liver bioassessment. The preoperative clinical and biological data and those checked at six and 12 months after surgery were collected from the patients’ medical records.

Results

The mean patients’ age was 34.65 ± 8.17 years and the sex-ratio was 0.21. The mean body mass index (BMI) was 50.23 ± 8.3 kg/m². Fifteen percent of our patients had hepatic cytolysis and 12% had anicteric cholestasis. Fatty liver disease was noted in 62% of patients. After sleeve gastrectomy, blood levels in transaminases decreased significantly (P < 0.01). No patients had hepatic cytolysis one year after the intervention. Also, blood levels of gamma-glutamyl transferase decreased significantly (P < 0.05). Only one patient retained anicteric cholestasis one year after surgery. Of the 25 patients with hepatic steatosis initially, four had had an abdominal ultrasound control which confirmed the absence of this abnormality. The mean excess weight loss was 40.2 ± 14% [4.1–74.6] at six months and 55.8 ± 20.5% [7.3–90.1] at one year. More than half of our patients lost more than 50% of their excess weight one year after sleeve gastrectomy.

Conclusion

Results of our study testify to the effectiveness of sleeve gastrectomy in improving parameters of liver function. This would be explained not only by the significant weight loss induced by this surgical technique but also by the metabolic changes such as increased levels of incretin thus improving insulin sensibility of patients and their metabolic parameters.