Jirapinyo Pichamol, Thompson Christopher C
Division of Gastroenterology, Hepatology and Endoscopy, Brigham and Women's Hospital, 75 Francis Street, Boston, MA, 02115, USA.
Harvard Medical School, Boston, MA, USA.
Curr Gastroenterol Rep. 2018 Sep 22;20(10):49. doi: 10.1007/s11894-018-0653-6.
Nonalcoholic steatohepatitis (NASH) is a spectrum of nonalcoholic fatty liver disease (NAFLD). It is defined as the presence of fatty liver along with inflammation and hepatocyte injury. To date, weight loss achieved via lifestyle intervention remains the mainstay of NASH treatment. However, given the known benefit of weight loss on NASH and the known effect of bariatric surgery on weight loss, several studies have explored the potential role of bariatric surgery on the treatment of NASH.
This review article summarizes the evidence on the effect of Roux-en-Y gastric bypass (RYGB), a common bariatric surgery, on NASH therapy. Specifically, studies show that RYGB is associated with an improvement of all NASH histologic features at 1 year. Compared to adjustable gastric band, RYGB appears to be superior at treating NASH. Randomized controlled trials and long-term studies are underway to better clarify the role of these procedures specifically for NASH therapy.
非酒精性脂肪性肝炎（NASH）是一系列非酒精性脂肪性肝病（NAFLD）。它被定义为存在脂肪肝以及炎症和肝细胞损伤。迄今为止，通过生活方式干预实现体重减轻仍然是NASH治疗的主要方法。然而，鉴于体重减轻对NASH的已知益处以及减重手术对体重减轻的已知效果，多项研究探讨了减重手术在NASH治疗中的潜在作用。
这篇综述文章总结了关于常见减重手术—— Roux-en-Y胃旁路术（RYGB）对NASH治疗效果的证据。具体而言，研究表明RYGB与1年后所有NASH组织学特征的改善相关。与可调节胃束带相比，RYGB在治疗NASH方面似乎更具优势。随机对照试验和长期研究正在进行中，以更好地阐明这些手术在NASH治疗中的具体作用。
