- Endoscopic sleeve gastroplasty provides more weight loss in obese patients with nonalcoholic fatty liver disease (NAFLD).
Why this matters
- NAFLD accounts for more than two-thirds of patients with chronic liver disease in the United States.
- Many patients cannot lose enough weight with conventional lifestyle modifications and pharmacotherapy.
- Some can benefit from bariatric surgery.
- A less invasive approach to bariatric surgery could allow wider treatment.
- Endoscopic sleeve gastroplasty, also known as the accordion procedure, uses an endoscopic suturing device to reduce the size of the stomach.
- The minimally invasive procedure has a reduced risk of complications.
- 5-year longitudinal study.
- 203 consecutive patients underwent endoscopic sleeve gastroplasty, performed by 1 surgeon.
- Two-thirds were female.
- 176 met the study criteria.
- All patients had NAFLD.
- Patients were followed for at least 1 year.
- Average BMI before surgery was 39 kg/m2, decreasing to 34 kg/m2 at the end of follow-up (P<.0001>
- Average weight loss was 13% (P<.0001>
- During follow-up, average alanine aminotransferase levels decreased significantly, as did average aspartate aminotransferase levels.
- Patients showed significant improvement in NAFLD as determined by Hepatic Steatosis Index and FIB(fibrosis)-4 score pre- and postoperative evaluations.
- The study was not a randomized, placebo-controlled trial.