Cazzo Everton, Gestic Martinho Antonio, Utrini Murillo Pimentel, Chaim Felipe David Mendonça, Callejas-Neto Francisco, Pareja José Carlos, Chaim Elinton Adami
MD, PhD, Assistant Lecturer, Department of Surgery, Faculdade de Ciências Médicas, Universidade Estadual de Campinas (Unicamp), Campinas, SP, Brazil.
MD, MSc, Assistant Lecturer, Department of Surgery, Faculdade de Ciências Médicas, Unicamp, Campinas, SP, Brazil.
Rev Assoc Med Bras (1992). 2017 Feb;63(2):190-194. doi: 10.1590/1806-9282.63.02.190.
: Bariatric surgery has become the gold standard treatment for morbid obesity, but there is no consensus regarding its safety and efficacy among individuals with chronic liver diseases.
: To critically evaluate the existing evidence on literature about bariatric surgery in individuals with liver cirrhosis.
: Narrative review performed by means of an online search in the MEDLINE and LILACS databases.
: Bariatric surgery is safe and effective in individuals with chronic liver disease without clinical decompensation or significant portal hypertension. Individuals with severe liver function impairment present significantly higher surgical morbidity and mortality. Among candidates to liver transplantation, surgery may be performed before, after and even during transplantation, and there is a predominant trend to perform it after. Vertical sleeve gastrectomy seems to be the most adequate technique in this group of subjects.
: Bariatric surgery is safe and effective in individuals with compensated cirrhosis without significant portal hypertension, but presents higher morbidity. Among candidates to liver transplantation and/or individuals with severe portal hypertension, morbidity and mortality are significantly higher.
减重手术已成为病态肥胖的金标准治疗方法，但对于慢性肝病患者，其安全性和有效性尚无共识。
批判性评估关于肝硬化患者减重手术的现有文献证据。
通过在MEDLINE和LILACS数据库中进行在线搜索进行叙述性综述。
减重手术对于无临床失代偿或严重门静脉高压的慢性肝病患者是安全有效的。肝功能严重受损的患者手术发病率和死亡率显著更高。在肝移植候选者中，手术可在移植前、移植后甚至移植期间进行，且主要趋势是在移植后进行。垂直袖状胃切除术似乎是这类患者中最合适的技术。
减重手术对于无严重门静脉高压的代偿期肝硬化患者是安全有效的，但发病率较高。在肝移植候选者和/或严重门静脉高压患者中，发病率和死亡率显著更高。
