Endoscopic Sleeve Gastroplasty for non-alcoholic Fatty Liver Disease

Aims ​​​​Adequate weight loss can lead to reduction in steatosis, inflammation and fibrosis in patients with obesity and non-alcoholic fatty liver disease(NAFLD). We evaluated role of endoscopic sleeve gastroplasty(ESG) in patient with obesity and NAFLD.

Methods ​​​​In this single center prospective study, consecutive patients with NAFLD who underwent ESG between November 2018 to May 2019 were included. The primary outcome was the impact of ESG on hepatic parameters: change in ALT, hepatic steatosis index(HSI), NAFLD fibrosis score(NFS), FIB–4 index(FIB-4) and aspartate aminotransferase(AST)-to-platelet ratio index(APRI) from baseline to 6 and 12 months. Secondary outcomes included change in HbA1c, percentage weight loss and safety. Analysis of variance with repeated measures was used for statistical analysis.

Results A total of 26 patients (mean age(SD) 41.5(9.58)years;16 females) with mean(SD) weight of 99.43(21.89) at baseline were included. There was significant improvement in ALT (mean ± SD) from baseline of 59.54 ± 17.02 to 49.50 ± 11.72 and 48.42 ± 13.22 at 6 and 12 months (p 0.001). Mean(SD) NFS was significantly improved from 0.228(1.00) at baseline to -0.202(1.16) and -0.552 (1.08) at 6 and 12 months(p 0.001). Mean(SD) HSI, FIB-4 and APRI scores significantly reduced from baseline to 6 and 12 months(p 0.001). There was 18.07 % total body weight loss at 12 months, with significant improvement in HbA1c. There were no major adverse events.

Conclusions ESG is a safe and effective treatment option for NAFLD and obesity by achieving significant weight loss. Rigorous randomized trials are required to incorporate ESG in NAFLD treatment algorithm.

Citation: Jagtap N, Kalapala R, Katakwar A et al. OP46 ENDOSCOPIC SLEEVE GASTROPLASTY FOR NON-ALCOHOLIC FATTY LIVER DISEASE. Endoscopy 2021; 53: S21.

Publication History

Article published online:
19 March 2021