{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,12]],"date-time":"2026-03-12T07:00:10Z","timestamp":1773298810398,"version":"3.50.1"},"reference-count":97,"publisher":"Georg Thieme Verlag KG","issue":"04","license":[{"start":{"date-parts":[[2021,7,9]],"date-time":"2021-07-09T00:00:00Z","timestamp":1625788800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Semin Liver Dis"],"published-print":{"date-parts":[[2021,11]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>The burden of obesity and metabolic syndrome has determined a sharp increase in bariatric surgery (BS) procedures, which lead to marked weight loss, improved metabolic syndrome, reduced cardiovascular risk, and even improvement in nonalcoholic steatohepatitis (NASH). Despite these promising results, BS in patients with chronic liver disease can rarely lead to worsening of liver function, progression to cirrhosis and its complications, and even liver transplantation. On the other hand, since obesity in patients with cirrhosis is a major cofactor for progression to a decompensated stage of the disease and a risk factor for hepatocellular carcinoma, BS has been used to achieve weight loss in this population. In this review, we critically analyze the existing data on outcomes of BS in patients with cirrhosis and the possible mechanisms leading to fibrosis progression and worsening liver function in patients undergoing BS. Finally, we propose a set of measures that could be taken to improve the multidisciplinary management of liver disease in patients undergoing BS, including early recognition of malnutrition and alcohol misuse.<\/jats:p>","DOI":"10.1055\/s-0041-1731705","type":"journal-article","created":{"date-parts":[[2021,7,9]],"date-time":"2021-07-09T23:50:17Z","timestamp":1625874617000},"page":"448-460","source":"Crossref","is-referenced-by-count":15,"title":["Risks and Rewards of Bariatric Surgery in Advanced Chronic Liver Diseases"],"prefix":"10.1055","volume":"41","author":[{"given":"Yuly P.","family":"Mendoza","sequence":"additional","affiliation":[{"name":"Department of Hepatology, University Clinic for Visceral Surgery and Medicine, Inselspital, Bern University Hospital, University of Bern, Switzerland"},{"name":"Hepatology, Department of Biomedical Research, University of Bern, Switzerland"},{"name":"Graduate School for Health Sciences (GHS), University of Bern, Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chiara","family":"Becchetti","sequence":"additional","affiliation":[{"name":"Department of Hepatology, University Clinic for Visceral Surgery and Medicine, Inselspital, Bern University Hospital, University of Bern, Switzerland"},{"name":"Hepatology, Department of Biomedical Research, University of Bern, Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kymberly D.","family":"Watt","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology, Department of Internal Medicine, Mayo Clinic, Rochester, Minnesota"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Annalisa","family":"Berzigotti","sequence":"additional","affiliation":[{"name":"Department of Hepatology, University Clinic for Visceral Surgery and Medicine, Inselspital, Bern University Hospital, University of Bern, Switzerland"},{"name":"Hepatology, Department of Biomedical Research, University of Bern, Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"194","published-online":{"date-parts":[[2021,7,9]]},"reference":[{"key":"ref1","doi-asserted-by":"crossref","first-page":"2627","DOI":"10.1016\/S0140-6736(17)32129-3","article-title":"Worldwide trends in body-mass index, underweight, overweight, and obesity from 1975 to 2016: a pooled analysis of 2416 population-based measurement studies in 128\u00b79 million children, adolescents, and adults","volume":"390","author":"NCD Risk Factor Collaboration (NCD-RisC)","year":"2017","journal-title":"Lancet"},{"issue":"04","key":"ref2","doi-asserted-by":"crossref","first-page":"457","DOI":"10.1016\/j.soard.2019.12.022","article-title":"American Society for Metabolic and Bariatric Surgery 2018 estimate of metabolic and bariatric procedures performed in the United States","volume":"16","author":"W J English","year":"2020","journal-title":"Surg Obes Relat Dis"},{"key":"ref3","doi-asserted-by":"crossref","first-page":"28","DOI":"10.1016\/j.peptides.2015.08.013","article-title":"The effect of bariatric surgery on gastrointestinal and pancreatic peptide hormones","volume":"77","author":"C L Meek","year":"2016","journal-title":"Peptides"},{"key":"ref4","doi-asserted-by":"crossref","first-page":"183","DOI":"10.1038\/nature13135","article-title":"FXR is a molecular target for the effects of vertical sleeve gastrectomy","volume":"509","author":"K K Ryan","year":"2014","journal-title":"Nature"},{"issue":"01","key":"ref5","doi-asserted-by":"crossref","first-page":"93","DOI":"10.1056\/NEJMc1714001","article-title":"Weight and metabolic outcomes 12 years after gastric bypass","volume":"378","author":"T D Adams","year":"2018","journal-title":"N Engl J Med"},{"issue":"10","key":"ref6","doi-asserted-by":"crossref","first-page":"786","DOI":"10.1016\/S2213-8587(19)30191-3","article-title":"Long-term adverse events after sleeve gastrectomy or gastric bypass: a 7-year nationwide, observational, population-based, cohort study","volume":"7","author":"J Thereaux","year":"2019","journal-title":"Lancet Diabetes Endocrinol"},{"issue":"01","key":"ref7","doi-asserted-by":"crossref","first-page":"172","DOI":"10.1016\/j.jhep.2018.06.024","article-title":"EASL Clinical Practice Guidelines on nutrition in chronic liver disease","volume":"70","author":"European Association for the Study of the Liver. 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