NtandjaWandji Line Carolle, Baud Gregory, Lassailly Guillaume
CHU de Lille, université de Lille, hôpital Huriez, service des maladies de l'appareil digestif, Lille, France.
CHU de Lille, université de Lille, hôpital Huriez, service de chirurgie générale et endocrinienne, Lille, France; Université de Lille, U1011, EGID, Inserm, Lille, France.
Presse Med. 2019 Dec;48(12):1502-1506. doi: 10.1016/j.lpm.2019.09.016. Epub 2019 Nov 19.
Bariatric surgery is indicated for patients with BMI≥35kg/m and associated steatohepatitis. Bariatric surgery induces NASH disappearance for nearly 80% of patients after 1 year of follow up. Bariatric surgery is associated with low morbidity and mortality if patients are well selected. Bariatric surgery is contraindicated in patients with cirrhosis. Long-term data are needed to determine the risk of recurrence of NASH. The extension of indications for bariatric surgery to patients with BMI less than 35kg/m will depend on the results of randomized trials.
对于体重指数（BMI）≥35kg/m²且伴有脂肪性肝炎的患者，建议进行减肥手术。减肥手术可使近80%的患者在随访1年后非酒精性脂肪性肝炎消失。如果患者选择得当，减肥手术的发病率和死亡率较低。肝硬化患者禁忌进行减肥手术。需要长期数据来确定非酒精性脂肪性肝炎复发的风险。将减肥手术适应症扩大到BMI小于35kg/m²的患者将取决于随机试验的结果。
