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Cited by 322Bariatric Surgery and OutcomesLiver Disease Diagnosis and TreatmentLiver Disease and Transplantation

The DOI matches its Crossref record; 69 of the 69 references it cites were found in a registry or an index.

Effects of surgical treatment of the metabolic syndrome on liver fibrosis and cirrhosis

Kral, John G, Thung, Swan N, Biron, Simon, Hould, Frederic-Simon, Lebel, Stefane, Marceau, Simon, Simard, Serge, Marceau, Picard·2004·Surgery
DOI 10.1016/j.surg.2003.10.003
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Abstract

Background Both weight loss and gastrointestinal surgery for obesity can cause liver disease, making their role in the treatment of obesity-related liver disease controversial. Methods Six hundred eighty-nine severely obese women (n=551) and men (n=138), BMI=47+/-9 kg.m(-2) (mean+/-SD), without known liver disease, underwent biliopancreatic diversion (BPD) with liver biopsy. Fourteen patients (2%) had cryptogenic cirrhosis, 11 of whom underwent multiple repeat biopsies. After 38+/-18 kg weight loss, 104 of the 689 patients underwent routine second biopsies during reoperations 41+/-25 months after BPD. All biopsy specimens were graded for steatosis, fibrosis, and inflammation by a blinded hepatopathologist. Results All 689 patients lost weight accompanied by improvements in the metabolic syndrome. Among the 104 patients who underwent reoperation, severe fibrosis (grade 3-5) decreased in 28 whereas mild fibrosis (grade 1-2) appeared in 42. Increased fibrosis was related to low-normal serum albumin, uncontrolled diarrhea, low intake of alcohol, and menopausal status. Fibrosis and inflammation decreased over time (P<.01). The 11 patients with cirrhosis exhibited decreased fibrosis from a mean grade 5 to grade 3, as well as reduced inflammation, Mallory bodies, and glycogenated nuclei. Seven patients had disappearance and 2 regression of nodules and fibrous bridging. Conclusions The metabolic syndrome of obesity is a determinant of liver fibrosis and cirrhosis, treatable by substantial weight loss after malabsorptive surgery.

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Crossref · 10.1016/j.surg.2003.10.003

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  1. Bowker, 1948, Bowker's test of symmetry, J Am Statistical Assoc, 43, 572, 10.2307/2280710 · DOI

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Metadata

Authors
Kral, J. G., Thung, S. N., Biron, S., Hould, F.-S., Lebel, S., Marceau, S., Simard, S., & Marceau, P.
Affiliations
State University of New York (US)
Corresponding author
Kral, John G
ORCID
Venue
Surgery
Publisher
Elsevier BV
Published
2004-01
Volume
135
Issue
1
Pages
48-58
ISSN
0039-6060 (ISSN-L)
DOI
10.1016/j.surg.2003.10.003
OpenAlex
W2075060360
Cited by
322
References
69
Citations by year
2026: 2 · 2025: 7 · 2024: 4 · 2023: 4 · 2022: 10 · 2021: 11 · 2020: 11 · 2019: 10 · 2018: 7 · 2017: 13 · 2016: 11 · 2015: 21 · 2014: 23 · 2013: 9 · 2012: 14
FWCI
17.62
Type
journal article
Language
en
Open access
closed
Licence
www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations
  • Surgery (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Surgery › Bariatric Surgery and Outcomes
  • Health Sciences › Medicine › Hepatology › Liver Disease Diagnosis and Treatment
  • Health Sciences › Medicine › Hepatology › Liver Disease and Transplantation
Keywords
metabolic syndrome, obesity, liver fibrosis, liver cirrhosis, biliopancreatic diversion, bariatric surgery, weight loss, malabsorptive surgery, obesity-related liver disease, liver biopsy, steatosis, liver inflammation, serum albumin, menopause, fibrosis regression
MeSH terms
Adult, Biopsy, Fatty Liver, Female, Hepatitis, Humans, Liver, Liver Cirrhosis, Male, Middle Aged, Obesity, Morbid, Reoperation, Weight Loss, Biliopancreatic Diversion, Case-Control Studies, Single-Blind Method, Treatment Outcome, Metabolic Syndrome

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