Metabolic liver disease is a condition that affects the liver’s ability to process nutrients and other substances. While it can be treated with medications and lifestyle changes, surgery is often the most effective option. In this article, we will explore the role of surgery in the treatment of metabolic liver disease, the types of surgeries available, and the potential risks and benefits.
A new study revealed that metabolic (bariatric) surgery is a more effective treatment option for advanced non-alcoholic fatty liver disease than medications and lifestyle interventions. This is the first research to compare three active treatments of non-alcoholic Steatohepatitis (NASH) and analyze the effectiveness of metabolic surgery (weight loss surgery) in a randomized clinical trial. Non-Alcoholic Fatty Liver Disease (NAFLD) is the primary cause of chronic liver disease, affecting over half of people with type 2 diabetes and three-quarters of those with obesity worldwide. Non-alcoholic steatohepatitis (NASH) is the progressive form of the disease, characterized by liver cell injury and inflammation, inducing liver fibrosis (tissue scarring). If left untreated, it can result in liver failure and liver cancer, and is a leading cause of liver transplant in Western countries. NAFLD/NASH increases the risk of cardiovascular disease and mortality in patients with obesity or type 2 diabetes. The study was a multi-center randomized trial conducted in Italy, comparing the effectiveness of bariatric and metabolic surgery vs lifestyle modifications and best current medical care in 288 patients. Researchers say the ability of surgery to control and improve fibrosis associated with NASH is of utmost clinical importance as fibrosis is the principal predictor of liver complications, poor cardiovascular outcomes, and death in NASH patients. Compared to conventional medical treatment, surgery also resulted in better overall health benefits. While both surgical procedures appeared to equally improve NASH, the gastric bypass group was more successful than sleeve gastrectomy in improving type 2 diabetes and reducing other cardiovascular risk factors linked to NAFLD/NASH. The study provides a compelling case for prioritizing metabolic surgery in a patient population with NASH, where the presence of NASH predicts a substantial risk of complications and mortality in patients with severe obesity and type 2 diabetes.
In conclusion, metabolic liver disease can be a devastating condition that can have a severe impact on a patient’s overall health and quality of life. While there are several treatment options available, surgery may be the best choice for some patients. Surgery can not only address the underlying cause of the disease, but it can also help prevent further damage and improve liver function. It is important to work closely with your healthcare provider to determine the best treatment plan for you, taking into account your individual health needs and goals. With the right treatment and support, it is possible to overcome metabolic liver disease and achieve a better quality of life.
