Utility and safety of routine liver biopsy during bariatric surgery

Show simple item record

dc.contributor.author Collins, H en
dc.contributor.author Beban, G en
dc.contributor.author Windsor, John en
dc.contributor.author Ram, R en
dc.contributor.author Evennett, N en
dc.contributor.author Loveday, Benjamin en
dc.coverage.spatial Pullman Albert Park, Melbourne, Australia en
dc.date.accessioned 2019-02-26T22:42:13Z en
dc.date.issued 2018-09-06 en
dc.identifier.uri http://hdl.handle.net/2292/45490 en
dc.description.abstract Utility and safety of routine liver biopsy during bariatric surgery Hannah Collins1, Grant Beban2, John Windsor2, Rishi Ram2, Nicholas Evennett2, Benjamin Loveday2 1North Shore Hospital, Auckland, New Zealand. 2Auckland City Hospital, Auckland, New Zealand Routine liver biopsy at the time of bariatric surgery may be performed due to the high prevalence of asymptomatic liver disease in this population. Its safety and utility in the New Zealand setting is undetermined. This retrospective cohort study aimed to establish the safety of liver biopsy during bariatric surgery, and determine how frequently it changed management. The study included all patients who underwent index bariatric surgery at Auckland City Hospital (2008-2016). Liver disease diagnosis was based on pathology reports. Safety outcomes were defined as bleeding or bile leak requiring transfusion or re-intervention. Utility outcomes were defined as further investigations, referral to a hepatologist or treatment initiated based on biopsy findings. Subgroup analyses were performed to identify differences for ethnic minorities. 71% (238/335) of bariatric surgery patients underwent intraoperative liver biopsy. There were no biopsy-related complications. Histological findings were normal in 11% (25/238), non-alcoholic fatty liver disease (NAFLD) in 87% (207/238), and fibrosis ≥stage F3, cirrhosis or other finding that met criteria for referral in 8% (18/238). Among patients who met referral criteria, 72% (13/18) were referred. Maori patients had a similar rate of NAFLD to non-Maori (84% (49/58) vs 88% (158/180),p=0.52) while Pacific Island patients had a statistically significant higher rate than non-Pacific Island (98% (39/40) vs 85% (168/198),p=0.03). When referral criteria were met, Maori and Pacific Island patients had non-significant higher referral rates (86% (6/7) vs 64% (7/11),p=0.31; 100% (2/2) vs 69% (11/16),p=0.35). On logistic regression, BMI was not predictive of normal histology (OR 0.92,p=0.12) or disease meeting referral criteria (OR 0.91,p=0.15). Routine intraoperative liver biopsy is safe and detects previously undiagnosed, clinically significant liver pathology in 8% of bariatric patients. Additionally, 87% have more mild NAFLD. Rates of subsequent referral of patients with advanced NAFLD are low and could be improved. en
dc.description.uri http://www.anzmoss2018.com.au/downloads/ANZMOSS-Presentations/Thursday/Hannah%20Collins%20-%204A%20-Thurs%201600.pdf en
dc.relation.ispartof Australian & New Zealand Metabolic and Obesity Surgery Society Conference 2018 en
dc.rights Items in ResearchSpace are protected by copyright, with all rights reserved, unless otherwise indicated. Previously published items are made available in accordance with the copyright policy of the publisher. en
dc.rights.uri https://researchspace.auckland.ac.nz/docs/uoa-docs/rights.htm en
dc.title Utility and safety of routine liver biopsy during bariatric surgery en
dc.type Conference Item en
dc.rights.holder Copyright: The author en
pubs.author-url http://www.anzmoss2018.com.au/ en
pubs.finish-date 2018-09-07 en
pubs.start-date 2018-09-06 en
dc.rights.accessrights http://purl.org/eprint/accessRights/RestrictedAccess en
pubs.subtype Conference Paper en
pubs.elements-id 754967 en
pubs.org-id Medical and Health Sciences en
pubs.org-id School of Medicine en
pubs.org-id Surgery Department en
pubs.org-id Science en
pubs.org-id Science Research en
pubs.org-id Maurice Wilkins Centre (2010-2014) en
pubs.record-created-at-source-date 2018-10-19 en

Files in this item

Find Full text

This item appears in the following Collection(s)

Show simple item record


Search ResearchSpace