ArticleObesity surgery2025
Bariatric Surgery and Risk of End-Stage Liver Disease in a Four-Country Cohort Study.
Article in Obesity surgery, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers, 2 of them syntheses that pooled it.
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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.
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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.
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Who cites it
4 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Alcohol-Related Liver Disease After Metabolic Bariatric Surgery: Reassessing the Hidden Risk-A Meta-Analysis.Obesity surgery · 2026Pooled it
- Prevalence of Liver Dysfunction After One-Anastomosis Gastric Bypass: A Systematic Review and Single-Arm Meta-analysis.Obesity surgery · 2025Pooled it
- Metabolic dysfunction-associated steatotic liver disease assessment and management: Clinical practice guidance from the Canadian Association for the Study of the Liver.Canadian liver journal · 2026Article
- Alcohol and Substance Use After Bariatric Surgery: Nutritional Risks and Clinical Implications in Long-Term Postoperative Care.Nutrients · 2026Review
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Authors and funding
6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundMetabolic dysfunction-associated steatotic liver disease can progress to end-stage liver disease. Whether bariatric surgery influences this risk is uncertain.
methodsThis population-based cohort study included all patients with an obesity diagnosis between 1989 and 2020 according to the nationwide patient registries in Denmark, Finland, Norway, and Sweden. Bariatric surgery was compared with non-operative care for incidence and mortality in end-stage liver disease. Patients with a history of alcohol overconsumption or liver disease at baseline were excluded. Multivariable Cox regression provided hazard ratios (HR) with 95% confidence intervals (CI), adjusted for sex, calendar year, diabetes, Charlson comorbidity index, and country.
resultsAmong 654,409 participants with obesity, 86,356 (12.6%) underwent bariatric surgery. During a follow-up period of up to 31 years (median 7.3 years), bariatric surgery was followed by increased incidence (HR 1.23, 95% CI 1.11-1.37) and mortality (HR 1.93, 95% CI 1.56-2.38) in end-stage liver disease compared to non-operative care. The incidence decreased between 1 and 5 years after bariatric surgery but thereafter increased. Censoring patients who developed specific liver diseases (not steatotic liver disease) or alcohol overconsumption during follow-up canceled the association (HR 0.92, 95% CI 0.70-1.06). The mortality in end-stage liver disease was similar after bariatric surgery compared to non-operative care within 1-5 years of follow-up, but thereafter more than twofold increased. Analyses restricted to gastric bypass showed similar associations regarding both incidence (HR 1.26, 95% CI 1.11-1.43) and mortality (HR 2.20, 95% CI 1.72-2.82) of end-stage liver disease.
conclusionBariatric surgery might be followed by an increased risk of end-stage liver disease.
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