Nonalcoholic fatty liver disease (
NAFLD) is closely related to patients with
obesity. For patients with
NAFLD,
bariatric surgery is the best treatment. However, the best technique to patient with severe
NAFLD is still unknown. Currently available, the imaging methods for assessing and monitoring
NAFLD are of limited use for diagnosing. In contrast, compared with liver biopsy and transient hepatic elastography (THE) has shown good accuracy in individuals with
obesity. To prospectively compare the evolution of THE parameters of
NAFLD right after the procedures:
gastric bypass vs sleeve
gastrectomy. Patients with
obesity were randomized into two groups:
gastric bypass and sleeve
gastrectomy in a previous study. Iin a previous study one week before and three months after surgery the patients underwent evaluation by THE. The patients were also analyzed with controlled attenuation parameter (CAP), which assesses the degree of hepatic steatosis using the same device. Sleeve
gastrectomy group showed a greater decrease in THE values (from 8.13 to 5.53 kPa) compared to the
gastric bypass group (from 9.25 to 8.81 kPa; P = .004). CAP also revealed a greater decrease in sleeve subjects (from 287 to 242 dB/m) compared to
gastric bypass subjects (from 290 to 276 dB/m; P < .0001). The absolute values of these differences also had a largest decrease with both methods in sleeve
gastrectomy group (P = .013 and P = .005 for THE and CAP, respectively).Sleeve
gastrectomy showed a greater decrease in both parameters (THE and CAP) than
gastric bypass in the first months.