As bariatric surgeons, we have a pivotal role in the overall health of patients with obesity. We commonly screen for many obesity-related conditions, such as obstructive sleep apnea, which most primary care physicians don’t have the time or awareness to address. Similarly, NASH/NALFD (now called MASLD or Metabolic Dysfunction-Associated Steatotic Liver Disease) is a ‘sneaky’ condition, where routine imaging and bloodwork can miss even advanced disease. Intraoperative biopsies are simple to perform, and a tissue diagnosis can positively influence the trajectory of the patient’s postoperative lifespan and healthspan. Session question – should bariatric surgeons be more proactively involved in liver health of our patients?

Learning Objectives

  1. Appreciate the etiology and prevalence of NASH/NAFLD/MASLD and current treatments.
  2. Understand the role of bariatric surgery in managing this disease process.
  3. Gain familiarity with preoperative, intraoperative, and postoperative considerations for patients with Steatotic Liver Disease.

3:45pm Introduction
Vance Albaugh, MD PhD; Laura Doyon, MD; Michel Murr, MD; Andres Sanchez-Pernaute, MD/PhD
3:47pm Polling
3:57pm State of NASH/NAFLD in US (abroad)
Monica Tincopa
4:06pm Preop EGD/EUS + sheerwave elastography
4:15pm Intraoperative wedge biopsy; video.
Laura Doyon, MD; Vance Albaugh, MD PhD
4:24pm Postop management (ie now what do I do with my biopsy?
Monica Tincopa
4:33pm Liver transplant: Before and after bariatric surgery?
Satish Nadig, MD PhD
4:42pm Video potpourri – Practical tips on operating with Fatty/Cirrhotic “nightmare livers”
Rana C Pullatt, MD
4:51pm Conclusions
Michel Murr, MD
5:00pm Polling
5:10pm Question and Answer
5:15pm Adjourn