Are Noninvasive Methods Comparable to Liver Biopsy in Postoperative Patients After Roux-en-Y Gastric Bypass?
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ORIGINAL CONTRIBUTIONS
Are Noninvasive Methods Comparable to Liver Biopsy in Postoperative Patients After Roux-en-Y Gastric Bypass? Pedro Funari Pereira 1 & Vinicius Von Diemen 1 & Eduardo Neubarth Trindade 1 & Matheus Truccolo Michalczuk 2 & Carlos Thadeu Schmidt Cerski 3 & Anderson Correa Mussi 4 & Debora Figueiro Aldabe 3 & Raphael Nicola Branchi 1 & Pedro Glusman Knijnik 5 & Pietro Waltrick Brum 5 & Mario Reis Alvares-da-Silva 2 & Manoel Roberto Maciel Trindade 1
# Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract Introduction Transient tissue elastography (TTE) may estimate the degree of hepatic fibrosis in patients with obesity, but the method has restrictions that are mainly related to patients’ BMI. Purpose To compare the results of the evaluation of hepatic fibrosis by biochemical methods and TTE with those determined by liver biopsy in patients after RYGB. Methods This was a cross-sectional study involving patient data, TTE, and liver biopsy 1 year after RYGB. Results Of the 94 selected patients, 33 underwent TTE and liver biopsy. The average weight of patients was 84.4 ± 15.4 kg. The mean APRI was 0.2 ± 0.1, and 36 patients (97.3%) were classified as F0–F1. The average NFS was − 2.0 ± 1.0, with 25 patients (67%) classified as F0–F1 and 12 patients (32.4%) classified as F2. The agreement rate between Fibroscan and liver biopsy was 80.0%. Histological analysis revealed regression of inflammatory changes in all patients: 26 patients (72.2%) had some degree of non-alcoholic steatohepatitis (NAS ≥ 5), and after surgery, no patient presented inflammation upon biopsy. Nine patients (24.3%) had fibrosis at surgery, and only two (5.4%) still had fibrosis 1 year later (p < 0.008). Conclusions The use of APRI and Fibroscan is promising, but more studies are needed to evaluate patients with an advanced degree of NAFLD and confirm the entire spectrum of the disease. Keywords NAFLD . Fibroscan . Gastric bypass . Liver biopsy . APRI
Introduction Electronic supplementary material The online version of this article (https://doi.org/10.1007/s11695-020-04513-4) contains supplementary material, which is available to authorized users. * Pedro Funari Pereira [email protected] 1
Digestive Surgery Department, Hospital de Clinicas de Porto Alegre, Rua Ramiro Barcelos, 2350, Porto Alegre, Rio Grande do Sul, Brazil
2
Gastroenterology Department, Hospital de Clinicas de Porto Alegre, Rua Ramiro Barcelos, 2350, Porto Alegre, Rio Grande do Sul, Brazil
3
Pathology Department, Hospital de Clinicas de Porto Alegre, Rua Ramiro Barcelos, 2350, Porto Alegre, Rio Grande do Sul, Brazil
4
Pathology Department, Centro de Anatomia Patológica, Rua General Osório, 1153, Pelotas, Rio Grande do Sul, Brazil
5
Faculty of Medicine, Universidade Federal do Rio Grande do Sul, Rua Ramiro Barcelos, 2400, Porto Alegre, Rio Grande do Sul, Brazil
Currently, non-alcoholic fatty liver disease (NAFLD) is the leading cause of chronic liver disease worldwide [1]. The spectrum of the disease includes steatosis, stea
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