Prospective randomized study to compare between the effect of sleeve gastrectomy and mini-gastric bypass on nonalcoholic steatohepatitis in morbidly obese patients

Background Most of morbidly obese patients have a variety of metabolic diseases. One of them is nonalcoholic fatty liver diseases); therefore, bariatric procedures like sleeve and mini-gastric bypass (MGB) help in significant weight reduction that may help in improving liver condition. Patients and methods The study was conducted at Bariatric Surgery Department of Ain Shams University Hospitals during the period from November 2018 to December 2020. It included 30 patients who were morbidly obese and had nonalcoholic steatohepatitis proved by liver biopsy taken intraoperative. In total, 14 patients underwent laparoscopic-sleeve gastrectomy and 16 patients underwent laparoscopic MGB. Results There was significant improvement in both controlled attenuation parameter (CAP) and kilopascals (kPa) after 1 year in both bariatric procedures. CAP declined in sleeve from 323.93 +/- 37.09 to 253.79 +/- 18.36 with P value of 0.000 and in bypass declined from 345.06 +/- 35.14 to 249.31 +/- 13.96 with P value of 0.000. kPa declined in sleeve from 8.85 +/- 2.73 to 6.96 +/- 2.19 and in bypass patients declined from 10.40 +/- 2.52 to 7.48 +/- 1.92 with P value of 0.000, with superiority for MGB over sleeve in both CAP and kPa with P value of 0.041 and 0.006, respectively. Conclusion The results of our study suggest that laparoscopic-sleeve gastrectomy and MGB are associated with significant improvement in liver steatosis and fibrosis with significant superiority for MGB over sleeve and FibroScan might be a useful adjunct to evaluate the effects of bariatric surgery on liver steatosis and fibrosis.