The beneficial impact of nutritional treatment in non-cirrhotic patients with acute liver decompensation after bariatric surgery

2021 ◽  
Vol 46 ◽  
pp. S657-S658
Author(s):  
P. Vande Berg ◽  
A. Ulaj ◽  
G. de Broqueville ◽  
M. de Vos ◽  
B. Delire ◽  
...  
Keyword(s):  
Bariatric Surgery ◽  
Nutritional Treatment ◽  
Liver Decompensation ◽  
Beneficial Impact ◽  
Cirrhotic Patients

Beneficial Impact of Group Psychotherapy on Depression and Quality of Life in Cirrhotic Patients on the Liver Transplant Waiting List

2018 ◽  
Vol 102 ◽  
pp. S610-S611
Author(s):  
Beatriz Febrero ◽  
Pablo P Ramírez ◽  
Laura L Martínez-Alarcón ◽  
Cristina C Abete ◽  
Montse M Galera ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Liver Transplant ◽  
Group Psychotherapy ◽  
Waiting List ◽  
Beneficial Impact ◽  
Cirrhotic Patients ◽  
Liver Transplant Waiting List

scholarly journals Bariatric Surgery in Cirrhotic Patients: Is It Safe?

2019 ◽  
Vol 30 (4) ◽  
pp. 1241-1248 ◽  
Author(s):  
Hafsa Younus ◽  
Amit Sharma ◽  
Rosa Miquel ◽  
Alberto Quaglia ◽  
Subba Rao Kanchustambam ◽  
...  
Keyword(s):  
Bariatric Surgery ◽  
Liver Disease ◽  
Postoperative Complications ◽  
Length Of Stay ◽  
Class Iii ◽  
Alcoholic Fatty Liver ◽  
Long Term Outcome ◽  
Bariatric Patients ◽  
Cirrhotic Patients

Abstract Introduction Ten percent of cirrhotic patients are known to have a high risk of postoperative complications. Ninety percent of bariatric patients suffer from non-alcoholic fatty liver disease (NAFLD), and 50% of them may develop non-alcoholic steatohepatitis (NASH) which can progress to cirrhosis. The aim of this study was to assess whether the presence of cirrhosis at the time of bariatric surgery is associated with an increased rate and severity of short- and long-term cirrhotic complications. Methods A cohort of 110 bariatric patients, between May 2003 and February 2018, who had undergone liver biopsy at the time of bariatric surgery were reassessed for histological outcome and divided into two groups based on the presence (C, n = 26) or absence (NC, n = 84) of cirrhosis. The NC group consisted of NASH (n = 49), NAFLD (n = 24) and non-NAFLD (n = 11) liver histology. Medical notes were retrospectively assessed for patient characteristics, development of 30-day postoperative complications, severity of complications (Clavien-Dindo (CD) classification) and length of stay. The C group was further assessed for long-term cirrhosis-related outcomes. Results The C group was older (52 years vs 43 years) and had lower BMI (46 kg/m2 vs 52 kg/m2) and weight (126 kg vs 145 kg) compared to the NC group (p < 0.05). The C group had significantly higher overall complication rate (10/26 vs 14/84, p < 0.05) and severity of complications (CD class ≥ III, 12% vs 7%, p < 0.05) when compared to the NC group. The length of stay was similar between the two groups (5 days vs 4 days). The C group had significant improvement in model end-stage liver disease scores (7 vs 6, p < 0.01) with median follow-up of 4.5 years (range 2–11 years). There were no long-term cirrhosis-related complications or mortality in our studied cohort (0/26). Conclusion Bariatric surgery in cirrhotic patients has a higher risk of immediate postoperative complications. Long-term cirrhosis-related complications or mortality was not increased in this small cohort. Preoperative identification of liver cirrhosis may be useful for risk stratification, optimisation and informed consent. Bariatric surgery in well-compensated cirrhotic patients may be used as an aid to improve long-term outcome.

Bariatric Surgery in Cirrhotic Patients: a Matched Case-Control Study

2020 ◽  
Vol 30 (12) ◽  
pp. 4724-4731 ◽  
Author(s):  
Nicolás Quezada ◽  
Gregorio Maturana ◽  
María Jesús Irarrázaval ◽  
Rodrigo Muñoz ◽  
Sebastián Morales ◽  
...  
Keyword(s):  
Bariatric Surgery ◽  
Case Control Study ◽  
Case Control ◽  
Cirrhotic Patients ◽  
Matched Case ◽  
Matched Case Control Study ◽  
Control Study

scholarly journals Acute Brucellosis and Cirrhosis: The Triggering Event of Fatal Liver Decompensation

2020 ◽  
Vol 2020 ◽  
pp. 1-4
Author(s):  
Maria Kosmidou ◽  
Eleftherios Klouras ◽  
Iro Rapti ◽  
Sebastien Filippas-Ntekouan ◽  
Haralampos Milionis
Keyword(s):  
Alcoholic Cirrhosis ◽  
Reticuloendothelial System ◽  
Infectious Complications ◽  
Hepatic Decompensation ◽  
Fatal Liver ◽  
Worldwide Distribution ◽  
Hepatic Involvement ◽  
Liver Decompensation ◽  
Triggering Factor ◽  
Cirrhotic Patients

Cirrhotic patients are known to be particularly susceptible to infectious complications that may vary according to regional endemic patterns. Brucellosis, a common zoonosis with worldwide distribution, exhibits a predilection for the reticuloendothelial system and thus resulting in hepatic involvement. We describe three cirrhotic patients in whom acute brucellosis and/or its treatment served as the triggering factor of hepatic decompensation, with deleterious effects. The patients suffered from alcoholic cirrhosis and culture-proven brucellosis. All patients came from an area endemic to brucellosis. The first patient exhibited a relapsing brucellosis course with progressive deterioration of his fragile liver function. The second patient progressed rapidly to jaundice, possibly partly attributed to antibiotic pharmacotoxicity, and died during liver transplantation. The third patient eventually succumbed to diffuse intravascular coagulation. Brucellosis can be a triggering event of fatal liver decompensation in cirrhotic patients. Enhancing health literacy of the patients, particularly in endemic areas, is of paramount importance for prevention of exposure to similar pathogens.

Safety and Efficacy of Bariatric Surgery in Patients with Cirrhosis

2018 ◽  
Author(s):  
Hideharu Shimizu ◽  
Tomasz G. Rogula ◽  
Philip R. Schauer
Keyword(s):  
Bariatric Surgery ◽  
Sleeve Gastrectomy ◽  
Metabolic Diseases ◽  
Bariatric Procedure ◽  
Morbidly Obese ◽  
Class A ◽  
Bariatric Patients ◽  
Pugh Class ◽  
Cirrhotic Patients ◽  
Perioperative Risks

Perioperative risks for morbidly obese patients with cirrhosis are significant, and surgeons should consider these risks carefully in deciding on the type of bariatric procedure to be performed. The benefits of bariatric surgery for cirrhotic patients include substantial weight loss, improvements in metabolic diseases, and potential regression of fibrosis, which can also increase their eligibility and candidacy for liver transplantation. There is currently a lack of strong evidence, but the restrictive bariatric procedures are the safest options for carefully selected patients with cirrhosis. Sleeve gastrectomy is likely the best bariatric procedure for obtaining good outcomes without a prohibitive complication rate or mortality for patients with compensated, Child-Pugh class A cirrhosis without portal hypertension. Roux-en-Y gastric bypass is also appropriate for patients who are not suitable for sleeve gastrectomy. Surgeons should be prepared in case they see bariatric patients with cirrhosis diagnosed preoperatively or intraoperatively.

scholarly journals Risk Factors for Liver Decompensation and HCC in HCV-Cirrhotic Patients after DAAs: A Multicenter Prospective Study

Cancers ◽  
2021 ◽  
Vol 13 (15) ◽  
pp. 3810
Author(s):  
Filomena Morisco ◽  
Alessandro Federico ◽  
Massimo Marignani ◽  
Mariarita Cannavò ◽  
Giuseppina Pontillo ◽  
...  
Keyword(s):  
Risk Factors ◽  
Regression Analysis ◽  
Cox Regression ◽  
Independent Predictor ◽  
Liver Stiffness ◽  
Cox Regression Analysis ◽  
Liver Decompensation ◽  
Cirrhotic Patients ◽  
Multicenter Prospective Study

Background: Prospective studies on predictors of liver-related events in cirrhotic subjects achieving SVR after DAAs are lacking. Methods: We prospectively enrolled HCV cirrhotic patients in four Italian centers between November 2015 and October 2017. SVR and no-SVR cases were compared according to the presence or absence of liver-related events during a 24-month follow-up. Independent predictors of liver-related events were evaluated by Cox regression analysis. Results: A total of 706 subjects started DAAs therapy. SVR was confirmed in 687 (97.3%). A total of 61 subjects (8.9%) in the SVR group and 5 (26.3%) in the no-SVR group had liver-related events (p < 0.03). The incidence rate x 100 p/y was 1.6 for HCC, 1.7 for any liver decompensation, and 0.5 for hepatic death. Baseline liver stiffness (LSM) ≥ 20 kPa (HR 4.0; 95% CI 1.1–14.1) and genotype different from 1 (HR 7.5; 95% CI 2.1–27.3) were both independent predictors of liver decompensation. Baseline LSM > 20 KPa (HR 7.2; 95% CI 1.9–26.7) was the sole independent predictor of HCC. A decrease in liver stiffness (Delta LSM) by at least 20% at the end of follow-up was not associated with a decreased risk of liver-related events. Conclusion: Baseline LSM ≥ 20 kPa identifies HCV cirrhotic subjects at higher risk of liver-related events after SVR.

Su1500 – Outcomes of Cirrhotic Patients with Prior Bariatric Surgery

2019 ◽  
Vol 156 (6) ◽  
pp. S-1285-S-1286
Author(s):  
Jonah N. Rubin ◽  
Filipa Ligeiro ◽  
Sasan Sakiani ◽  
Nathalie H. Urrunaga
Keyword(s):  
Bariatric Surgery ◽  
Cirrhotic Patients

Mo1176 Nutritional Treatment of Patients After Bariatric Surgery: Importance of Protein Supplement

2012 ◽  
Vol 142 (5) ◽  
pp. S-613
Author(s):  
Massimo Vincenzi ◽  
Barbara Paolini ◽  
Leonardo Di Cosmo ◽  
Giuseppe Vuolo ◽  
Cristina Ciuoli ◽  
...  
Keyword(s):  
Bariatric Surgery ◽  
Protein Supplement ◽  
Nutritional Treatment
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