The impact of bariatric surgery on nonalcoholic fatty liver disease.
OBJECTIVE
To analyze the effects of bariatric surgery on nonalcoholic fatty liver disease by reviewing the most important and recent studies.


RESULTS
The prevalence of obesity has increased dramatically over the last decades. Comorbidities related to obesity, such as nonalcoholic fatty liver disease are also increasing. Nonalcoholic fatty liver disease is a progressive disease with potential evolution to liver cirrhosis and hepatocellular carcinoma. Overweight patients who have nonalcoholic fatty liver disease should be considered for a weight loss program; however, long-term result with dietary interventions and drug therapy has been disappointing. Bariatric surgery is effective in promoting long-term weight loss in morbidly obese patients with control of comorbidities, especially those associated with the metabolic syndrome. On the basis of the early experience with extensive intestinal bypass, it was believed that rapid weight loss could cause liver damage. In contrast, recent prospective and retrospective observational studies and case series have demonstrated that bariatric surgery is well tolerated and is associated with nonalcoholic fatty liver disease regression in a significant number of patients.


CONCLUSIONS
There is good level of evidence that bariatric surgery is associated with nonalcoholic fatty liver disease regression in morbidly obese patients.
de Freitas
Alexandre Coutinho Teixeira
AC
Department of Surgery, Federal University of Parana, Curitiba, Brazil. alexandrefreitas@ufpr.br
Campos
Antonio Carlos Ligocki
AC
Coelho
Julio Cezar Uili
JC
D050110:Bariatric Surgery; D005234:Fatty Liver / Q000628:therapy*; D006801:Humans; D009767:Obesity, Morbid / Q000150:complications* / Q000601:surgery*; D017063:Outcome Assessment, Health Care; D016896:Treatment Outcome; D015431:Weight Loss / Q000502:physiology*