Clinical hepatic impairment after the duodenal switch

被引:37
作者
Baltasar, A [1 ]
Serra, C [1 ]
Pérez, N [1 ]
Bou, R [1 ]
Bengochea, M [1 ]
机构
[1] Hosp Virgen Lirios, Serv Cirugia Gen, Alicante 03804, Spain
关键词
nonalcoholic hepatic steatosis; biliopancreatic diversion; hepatic impairment; duodenal switch; morbid obesity; bariatric surgery;
D O I
10.1381/096089204772787338
中图分类号
R61 [外科手术学];
学科分类号
摘要
Background: Nonalcoholic steatohepatitis (NASH) is the most common histological finding in morbidly obese patients undergoing liver biopsy. Biliopancreatic diversion has been widely 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. Methods: During the last 9 years, 470 morbidly obese patients were operated by means of a bilio-pancreatic diversion with duodenal switch (BPD-DS), and 93 of them were performed laparoscopically. Results: 10 cases of clinical hepatic impairment occurred after the BPD-DS. The clinical course of these patients ranged from transient subclinical alterations of liver function tests to severe cases of jaundice and one death from liver failure. Conclusion: Randomized prospective studies with standardization of BPD-DS are needed, to know the real incidence of hepatic impairment and the proper treatment for this condition. Careful follow-up and correction of possible malnutrition should be addressed to avoid hepatic impairment and/or progression of liver disease.
引用
收藏
页码:77 / 83
页数:7
相关论文
共 38 条
  • [1] PREVENTION AND REVERSAL OF LIVER-DAMAGE FOLLOWING BILIOPANCREATIC DIVERSION FOR OBESITY
    ANTAL, SC
    [J]. OBESITY SURGERY, 1994, 4 (03) : 285 - 290
  • [2] Duodenal switch:: An effective therapy for morbid obesity -: Intermediate results
    Baltasar, A
    Bou, R
    Bengochea, M
    Arlandis, F
    Escrivá, C
    Miró, J
    Martínez, R
    Pérez, N
    [J]. OBESITY SURGERY, 2001, 11 (01) : 54 - 58
  • [3] Laparoscopic biliopancreatic diversion with duodenal switch:: Technique and initial experience
    Baltasar, A
    Bou, R
    Miró, J
    Bengochea, M
    Serra, C
    Pérez, N
    [J]. OBESITY SURGERY, 2002, 12 (02) : 245 - 248
  • [4] Baltazar H, 2002, EWEEK, V19, P54
  • [5] Liver transplantation in a case of steatohepatitis and subacute hepatic failure after biliopancreatic diversion for morbid obesity
    Castillo, J
    Fábrega, E
    Escalante, CF
    Sanjuan, JCR
    Herrera, L
    Hernánz, F
    Martino, E
    Casafont, F
    Fleitas, MG
    [J]. OBESITY SURGERY, 2001, 11 (05) : 640 - 642
  • [6] Are there predictive factors of severe liver fibrosis in morbidly obese patients with non-alcoholic steatohepatitis?
    Crespo, J
    Fernández-Gil, P
    Hernández-Guerra, M
    Cayón, A
    Mayorga, M
    Domínguez-Diez, A
    Fernández-Escalante, JC
    Pons-Romero, F
    [J]. OBESITY SURGERY, 2001, 11 (03) : 254 - 257
  • [7] Recommendations for reporting weight loss
    Deitel, M
    Greenstein, RJ
    [J]. OBESITY SURGERY, 2003, 13 (02) : 159 - 160
  • [8] DEITEL M, OBES SURG, V13, P329
  • [9] Liver damage in obese patients
    Del Gaudio, A
    Boschi, L
    Del Gaudio, GA
    Mastrangelo, L
    Munari, D
    [J]. OBESITY SURGERY, 2002, 12 (06) : 802 - 804
  • [10] Roux-en-Y gastric bypass for recurrent nonalcoholic steatohepatitis in liver transplant recipients with morbid obesity
    Duchini, A
    Brunson, ME
    [J]. TRANSPLANTATION, 2001, 72 (01) : 156 - 159