Hepatic Changes after Small-intestinal Bypass for Morbid Obesity

Liver biopsies of 30 patients obtained at the time of intestinal bypass procedures for morbid obesity were compared with liver biopsies obtained two to 133 months after the shunt. The extent of fatty change, as estimated by the approximate number of cells involved, and the presence and extent of inflammation and fibrosis were recorded. Twenty-eight of the 30 patients had at least some evidence of fatty metamorphosis in the first liver biopsy specimen. In all eight patients who underwent jejunocolic shunts the fatty changes were more severe in the second biopsy specimen, as was the case in ten of 22 patients with jejunoileal shunts. However, after weight stabilization, two years or longer after the shunt procedure, the hepatic parenchymal changes appeared the same or actually improved in eight of the 13 patients biopsied at that time and in three patients who underwent third biopsies.