Friday, July 17, 2015

Weight-loss surgery may cause liver failure

Weight-loss surgery is often sold as a magic pill for problems ranging from morbid obesity to diabetes. But few surgeons will warn you of severe side effects it may cause if precaution is not taken to assess the condition of the liver prior to the surgery. 

Institute of Liver and Biliary Sciences (ILBS), a state-run hospital for gastrointestinal illnesses in Delhi, has received at least three patients over the past one-and-a-half years with liver failure caused due to weight-loss surgery. 

The patient generally come to hospital with severe jaundice, abdominal pain and extreme weakness. Some of them may require to undergo a liver transplant for long-term survival.

Doctors say any surgery in a cirrhotic patient (whose liver is damaged due to long-term scarring) is risky. In case of weight-loss surgery, which involves reducing the size of the stomach, the bacteria or toxins excessively go into liver and cause further injury leading to failure.

According to some of the experts, liver failure in case of a patient who has undergone weight-loss surgery is as bad as an alcoholic's. The liver is so damaged that living donor transplant is not possible. Only a full-sized liver harvested from cadaver donor can match the graft size required.

The doctors suggest that any patient going for a weight-loss surgery must consider complete assessment of liver condition. Liver function test (LFT), may not give the real picture. Doctors should ideally use a fibroscan with extra lobe or MR spectroscopy to rule out cirrhotic liver.

If the liver is found to be cirrhotic, then surgery should be considered carefully and with respect to the health risks involved. Also, such patients should not starve themselves to lose weight rapidly. 

In India, an estimated 200 million people suffer from weight-related issues. According to Obesity Surgery Society of India, close to 2,000 persons undergo weight-loss surgery every year. Bariatric surgery involves stapling a portion of the stomach to reduce a person's appetite. 


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