Impact of multidisciplinary steatotic liver disease management on bariatric surgery referral and clinical outcomes: A retrospective cohort study

作者：Andrew W. Schwartz, Emily Y Park, Ysabel C Ilagan-Ying, Zoe E Zimmerman, Bryan Bollinger, Lee D Ying, Yanhong Deng, Andrew J Duffy, John M Morton, Wajahat Z. Mehal, Albert Do, Bubu A. Banini · 发表于：World Journal of Hepatology · 年份：2026 · DOI：10.4254/wjh.v18.i1.113753 · 被引用次数：1 · 研究领域：Liver Disease Diagnosis and Treatment、Bariatric Surgery and Outcomes、Diabetes, Cardiovascular Risks, and Lipoproteins

BACKGROUND Lifestyle modifications aimed at weight loss are key to improving metabolic dysfunction-associated steatotic liver disease (MASLD); however, achieving substantial and sustained weight loss through non-surgical approaches may be difficult for some patients. Bariatric surgery should be considered as a therapeutic option in select patients with MASLD, but the national referral rate for eligible patients is low (< 1%). AIM To examine referral rates and one-year outcomes among adults with MASLD in a multidisciplinary clinic integrating hepatology and obesity medicine. METHODS We performed a retrospective cohort study of 965 patients seen in a MASLD-specific clinic over a three-year period (2018-2022). Patients were categorized as bariatric surgery eligible or non-eligible based on standard referral criteria. We assessed bariatric surgery referral rates, weight, and liver-related outcomes, including change in nonalcoholic fatty liver disease fibrosis score. Categorical variables were compared with χ 2 tests, and continuous variables were analyzed with two-tailed t -tests. P value < 0.05 was considered significant. RESULTS Among 491 patients eligible for bariatric surgery, 127 patients (26%) were referred for surgical evaluation, with 31 patients (24%) ultimately undergoing bariatric surgery (21 sleeve gastrectomy and 10 Roux-en-Y gastric bypass). The remaining 96 patients continued with medication and/or lifestyle management. Individuals who underwent bariatric sur...