Feng Gong, Han Yu, Yang Wah, Shikora Scott, Mahawar Kamal, Cheung Tan To, Targher Giovanni, Byrne Christopher D, Hernandez-Gea Virginia, Tilg Herbert, Zheng Ming-Hua
Xi'an Medical University, Xi'an, China; The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China.
Department of Gastrointestinal Surgery, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China.
Trends Endocrinol Metab. 2025 Feb;36(2):118-132. doi: 10.1016/j.tem.2024.05.009. Epub 2024 Jun 21.
The prognosis of patients with decompensated cirrhosis is poor, with significantly increased liver-related mortality rates. With the rising tide of decompensated cirrhosis associated with metabolic dysfunction-associated steatotic liver disease (MASLD), the role of metabolic bariatric surgery (MBS) in achieving hepatic recompensation is garnering increasing attention. However, the complexity of preoperative assessment, the risk of postoperative disease recurrence, and the potential for patients to experience surgical complications of the MBS present challenges. In this opinion article we analyze the potential of MBS to induce recompensation in MASLD-related cirrhosis, discuss the mechanisms by which MBS may affect recompensation, and compare the characteristics of different MBS procedures; we highlight the therapeutic potential of MBS in MASLD-related cirrhosis recompensation and advocate for research in this complex area.
失代偿期肝硬化患者的预后较差，肝脏相关死亡率显著增加。随着与代谢功能障碍相关的脂肪性肝病（MASLD）相关的失代偿期肝硬化病例增多，代谢性减重手术（MBS）在实现肝脏代偿方面的作用日益受到关注。然而，术前评估的复杂性、术后疾病复发的风险以及患者发生MBS手术并发症的可能性都带来了挑战。在这篇观点文章中，我们分析了MBS诱导MASLD相关肝硬化代偿的潜力，讨论了MBS可能影响代偿的机制，并比较了不同MBS手术的特点；我们强调了MBS在MASLD相关肝硬化代偿中的治疗潜力，并倡导在这一复杂领域开展研究。
