Energy balance
Bariatric surgery, specifically Roux-en-Y gastric bypass, resolves non-alcoholic steatohepatitis (NASH) in approximately 85% of patients and regresses liver fibrosis, outperforming conservative lifestyle interventions.
For obese patients with fatty liver disease who have not achieved results with diet and exercise, Roux-en-Y gastric bypass is a highly effective treatment that can resolve NASH in the majority of cases and reverse fibrosis. It should be considered before liver damage becomes irreversible (cirrhosis).
In general, bariatric surgery results in resolution of NASH in the majority of patients (85% in a study by Lassailly et al[114], with 64.2% of patients undergoing bypass surgery and 5.5% of sleeve gastrectomiy) and regression of fibrosis[114].
Why this rating
Supported by prospective studies and meta-analyses, though the paper notes a need for more high-quality randomized trials.
Source
Individualized treatment options for patients with non-cirrhotic and cirrhotic liver disease
Lukas Hartl et al. · World Journal of Gastroenterology · 2021
DOI 10.3748/wjg.v27.i19.2281
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