Preoperative Hepatosteatosis and Postoperative Liver Function in Patients with Morbid Obesity after Biliopancreatic Derivation with Duodenal Switch

Materials and Methods: Retro-prospective study of 141 patients with morbid obesity treated with the surgical technique Biliopancreatic Derivation with Duodenal Switch (BPD DS) was performed between January, 2003 and June, 2012 in the University Hispital Center Albacete (Centro Hospitalario Universitario de Albacete - CHUA).Results: 141 patients with morbid obesity underwent surgery. Their average age was 41.8 (21-60), the average weight - 139.13kg (100-193kg), the average height - 164.22cm (141-192cm), and BMI - 51.91kg/m 2 (41.62-75.06 kg/m2). 124 patients had intraoperative liver biopsy. Nonalcoholic fatty liver disease (NAFLD) was found in 90.3% of patients with wide-ranging severity, and chronic hepatitis - in 1.6% of patients. A statistically significant correlation between the severity of NAFLD and BMI was not established. Postoperatively, the elevation of liver enzymes GOT and GPT was most significant in the first 3 months, but in the range 50- 100UI, and this is explained with the ongoing malabsorption. As time passed, the transaminase levels returned to normal and on the 5th year after the operation, 4.9% of patients had slightly elevated levels of GOT and GPT, below 100UI.Conclusion: Morbid obesity is a pathological state, which leads to hepatosteatosis in over 90% of the cases. BPD DS is a combined restrictive malabsorbtive technique, which does not lead to deterioration of the liver function in the presence of a lack of malnutritive conditions.