Considerations for bariatric surgery in patients with cirrhosis
Considerations for bariatric surgery in patients with cirrhosis作者机构：Department of Gastroenterology and HepatologySingapore General HospitalSingapore 169608Singapore Duke-NUS Graduate Medical SchoolSingapore 169608Singapore Bariatric and Metabolic InstituteCleveland ClinicClevelandOH 44195United States Department of GastroenterologyCleveland ClinicClevelandOH 44195United States Department of PathobiologyCleveland ClinicClevelandOH 44195United States
出 版 物：《World Journal of Gastroenterology》 (世界胃肠病学杂志（英文版）)
年 卷 期：2018年第24卷第28期
页 面：3112-3119页
核心收录：
主 题：Cirrhosis Portal hypertension Non-alcoholic fatty liver disease Bariatric surgery Complications
摘 要：With the ever increasing global obesity pandemic, clinical burden from obesity related complications are anticipated in parallel. Bariatric surgery, a treatment approved for weight loss in morbidly obese patients, has reported to be associated with good outcomes, such as reversal of type two diabetes mellitus and reducing all-cause mortality on a long term basis. However, complications from bariatric surgery have similarly been reported. In particular, with the onslaught of non-alcoholic fatty liver disease(NAFLD) epidemic, in associated with obesity and metabolic syndrome, there is increasing prevalence of NAFLD related liver cirrhosis, which potentially connotes more risk of specific complications for surgery. Bariatric surgeons may encounter, either expectedly or unexpectedly, patients with non-alcoholic steatohepatitis(NASH) and NASH related cirrhosis more frequently. As such, the issues and considerations surrounding their medical care/surgery warrant careful deliberation to ensure the best outcomes. These considerations include severity of cirrhosis, liver synthetic function, portal hypertension and the impact of surgical factors. This review explores these considerations comprehensively and emphasizes the best approach to managing cirrhotic patients in the context of bariatric surgery.
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