Evidence map›Paper›PMID 31446562›Full record

ArticleObesity surgery2020

Intraoperative Liver Biopsy During Adolescent Bariatric Surgery: Is It Really Necessary?

R Ellen Jones, Ann Ming Yeh, Neerajah Kambham, Marwa Abu El Haija, Janey Pratt, Matias Bruzoni

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Article in Obesity surgery, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
0.6field-weighted citation impact, top 29% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed, 8 citations in OpenAlex.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors at 1 institution in 1 country.

R Ellen JonesDepartment of Surgery, Division of Pediatric Surgery, Stanford University Medical Center, 300 Pasteur Dr Rm M116, Alway Bldg MC 5733, Stanford, CA, 94305, USA.
Ann Ming YehDepartment of Pediatrics, Division of Gastroenterology, Stanford University Medical Center, Stanford, CA, USA.
Neerajah KambhamDepartment of Clinical Pathology, Stanford University Medical Center, Stanford, CA, USA.
Marwa Abu El HaijaDepartment of Pediatrics, Division of Gastroenterology, Stanford University Medical Center, Stanford, CA, USA.
Janey PrattDepartment of Surgery, Division of Pediatric Surgery, Stanford University Medical Center, 300 Pasteur Dr Rm M116, Alway Bldg MC 5733, Stanford, CA, 94305, USA.
Matias BruzoniDepartment of Surgery, Division of Pediatric Surgery, Stanford University Medical Center, 300 Pasteur Dr Rm M116, Alway Bldg MC 5733, Stanford, CA, 94305, USA. mbruzoni@stanford.edu.ORCID 0000-0003-1502-2109
Stanford Medicine · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundNonalcoholic fatty liver disease (NAFLD) is prevalent in children with obesity and is definitively diagnosed with liver biopsy. However, the utility of routine biopsy during adolescent bariatric surgery remains unknown. We describe the usefulness of routine versus selective intraoperative liver biopsy in adolescents undergoing bariatric surgery.

methodsA retrospective review of adolescents who received bariatric surgery at our institution between 2007 and 2018 was performed. Prior to 2014, all patients routinely received intraoperative liver biopsy. After 2014, biopsy was performed selectively on an individual basis for transaminitis or clinical concern. Demographic, biochemical, and histopathologic data were compared between patients who underwent routine, selective, or no biopsy.

resultsThere were 77 patients who received bariatric surgery during the study period: 32 underwent routine biopsy, 13 selective biopsy, and 32 no biopsy. Selective liver biopsy was more likely to show pathologic evidence of fibrosis (84.6% versus 31.2%, p = 0.000) and steatosis (100.0% versus 59.4%, p = 0.003), and higher mean NAFLD activity score compared with routine biopsies (4.4 versus 2.1, p = 0.001). Patients with steatosis had significantly higher preoperative fasting insulin (41.4 versus 21.1 mIU/L, p = 0.000), and patients with fibrosis had significantly higher glycated hemoglobin (6.1% versus 5.5%, p = 0.033) and alanine aminotransferase (81.5 versus 52.7 mg/dL, p = 0.043). There were no biopsy complications or changes in management due to biopsy results.

conclusionsRoutine intraoperative liver biopsy during adolescent bariatric surgery possesses questionable benefit, as it does not appear to impact short-term postoperative management. Prospective, longitudinal studies are needed to better understand the meaningfulness of liver histopathology in this population.

Indexed as

Bariatric SurgeryAdolescentBiopsyCohort StudiesFemaleHumansIntraoperative CareIntraoperative PeriodLiverMaleNon-alcoholic Fatty Liver DiseaseObesity, MorbidPatient SelectionPediatric ObesityPredictive Value of TestsPrevalenceAdolescentBariatric surgeryLiver biopsyNonalcoholic fatty liver diseaseNonalcoholic steatohepatitisUtility

Identifiers

PMID31446562
OpenAlexW2969322877

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.