Liver Cirrhosis Improvement by Weight Loss Prior Bariatric Surgery

¹Department of Visceral, Transplantation, Thoracic and Vascular Surgery, University Hospital Leipzig, Germany

²Department of Pathology, University Hospital Leipzig, Germany

³Department of Internal Medicine, University Hospital Leipzig, Germany

*Corresponding Author:

Henning Spieker, M.D
Department of Visceral, Transplantation
Thoracic and Vascular Surgery, University Hospital Leipzig
Liebigstr. 20, 04103 Leipzig, Germany
Tel: 0049-341-9717200
Fax: 0049-341-9717209 E-mail: henning.spieker@medizin.uni-leipzig.de

Received date: July 26, 2016; Accepted date: August 26, 2016; Published date: February 07, 2017

Citation: Spieker H, Sändig I, Wittekind C, Blueher M, Dietrich A (2017) Liver Cirrhosis Improvement by Weight Loss Prior Bariatric Surgery. J Obes Weight Loss Ther 7:334. doi: 10.4172/2165-7904.1000334

Copyright: © 2017 Spieker H, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

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Abstract

Non-alcoholic fatty liver disease (NAFLD) as a phenotype of metabolic syndrome can lead to non-alcoholic steatohepatitis (NASH) and liver cirrhosis. Bariatric surgery in patients with liver cirrhosis can be related to possible bleeding complications due to resultant hypocoagulability. Therefore lifestyle-changing programmes are necessary in order to improve liver function until (bariatric) surgery is performed.

Keywords

Bariatric surgery; Liver cirrhosis; Major abdominal surgery; Perioperative risk; NAFLD; Lifestyle changing

Abbreviation

NAFLD: Non-Alcoholic Fatty Liver Disease; NASH: Non-Alcoholic Steatohepatitis; T2DM: Type 2 Diabetes Mellitus

Case Report

We report on a 61 year-old male patient suffering metabolic syndrome with known liver cirrhosis, showing no clinical signs or typical changes in blood samples, who underwent a laparoscopy in 2013 for planed Roux-Y-Bypass. Intra-operatively liver cirrhosis was seen and due to a tendency of bleeding the operation was stopped. Following consequent weight loss therapy (15 kg weight loss) relaparoscopy was performed 3 month later. There was no tendency towards bleeding and bariatric surgery (Roux-en-Y-gastric bypass) was performed. The liver cirrhosis improved histologically.

Conclusion

Bariatric procedures such as Roux-Y-Bypass can be safely performed with an appropriate risk in patients with liver cirrhosis. Suitable conditioning by sufficient weight loss helps to improve liver function in order to enable bariatric surgery under safe circumstances.