Year 2019 / Volume 111 / Number 4
Original
Bariatric and metabolic endoscopy in the handling of fatty liver disease. A new emerging approach?

283-293

DOI: 10.17235/reed.2019.5949/2018

Eduardo Espinet Coll, Carmen Vila Lolo, Patricia Díaz Galán, José Antonio Gómez Valero, Silvia Bacchiddu, Cristina Quintana Tomás, Daniel Irigoyen, Kattarina Gunnard, Antonio Juan-Creix Comamala,

Abstract
Background: non-alcoholic fatty liver disease (NAFLD) is the most frequent cause of chronic hepatopathy in our environment. However, the benefits of the bariatric endoscopy in this disease are barely documented. Objectives: to evaluate changes in NAFLD, via non-invasive methods in obese patients who underwent bariatric restrictive endoscopy. Weight, metabolic changes and the level of technical safety were also analyzed as secondary objectives. Methods: thirty patients with NAFLD and obesity (mean BMI 38.22 ± 6.55 kg/m2) underwent bariatric restrictive endoscopy; this included 15 one-year intragastric balloons and 15 sutured gastroplasties (ESG-Apollo®). A non-invasive prospective analysis was performed via analytical (hepatic function, insulin-resistance and hepatic steatosis/fibrosis scores) and ultrasonographic parameters. In addition, anthropometric features and the evolution of the main obesity-related comorbidities were evaluated. The follow-up period was one year in all cases. Results: thirty patients were included; 63% were female with a mean age of 46 ± 13.8 years. There was a decrease in FLI, HSI, NAFLD-Fibrosis Score, hepatic ultrasonographic steatosis, subcutaneous fat (p < 0.001), HOMA-IR, insulin and triglycerides (p < 0.05) after 12 months. An average EWL of 44.02% (16.34% TBWL) was obtained after one year, with EWL > 25% in 27/30 patients (TBWL > 10% in 25/30 patients) (p < 0.001). Obesity-related comorbidities were resolved in 17/30 (57%) of cases, 5/8 (62.5%) HTA, 5/12 (41.7%) DLP, 2/4 (50%) T2DM, 2/3 (66.7%) SOAS and 3/3 (100%) arthropathy. An improvement in HbA1c in the ESG-Apollo group (p = 0.017) was the only difference. One migrated and spontaneously expelled balloon was the only technical incidence. Conclusions: bariatric endoscopy could be proposed during short-term follow-up as an effective and safe alternative in patients with obesity and NAFLD. It stimulates weight loss and improves analytical and ultrasound parameters from hepatic fat, insulin-resistance and hypertriglyceridemia. It also improves associated major comorbidities.
Share Button
New comment
Comments
No comments for this article
Related articles

Review

Psoriasis and fatty liver: a harmful synergy

DOI: 10.17235/reed.2019.6263/2019

Letter to the Editor

GETTEMO position statement on bariatric endoscopic techniques as a voluntary medicine

DOI: 10.17235/reed.2017.5144/2017

Original

Multicenter study on the safety of bariatric endoscopy

DOI: 10.17235/reed.2017.4499/2016

Citation tools
Espinet Coll E, Vila Lolo C, Díaz Galán P, Gómez Valero J, Bacchiddu S, Quintana Tomás C, et all. Bariatric and metabolic endoscopy in the handling of fatty liver disease. A new emerging approach?. 5949/2018


Download to a citation manager

Download the citation for this article by clicking on one of the following citation managers:

Metrics
This article has received 1880 visits.
This article has been downloaded 546 times.

Statistics from Dimensions


Statistics from Plum Analytics

Publication history

Received: 30/09/2018

Accepted: 29/12/2018

Online First: 21/03/2019

Published: 04/04/2019

Article revision time: 82 days

Article Online First time: 172 days

Article editing time: 186 days


Share
This article has been rated by 15 readers.
Reader rating:
Valora este artículo:




Asociación Española de Ecografía Digestiva Sociedad Española de Endoscopia Digestiva Sociedad Española de Patología Digestiva
The Spanish Journal of Gastroenterology is the official organ of the Sociedad Española de Patología Digestiva, the Sociedad Española de Endoscopia Digestiva and the Asociación Española de Ecografía Digestiva
Cookie policy Privacy Policy Legal Notice © Copyright 2023 y Creative Commons. The Spanish Journal of Gastroenterology