Gastrectomia vertical (Sleeve) em paciente pós-transplante hepático

Abstract

Objectives: To describe the first case of bariatric surgery (Vertical Gastrectomy - Sleeve) in a patient undergoing liver transplantation, for the treatment of grade III obesity and severe graft steatosis at the Hospital Universitário Walter Cantídio (HUWC). Methodology: After approval by the HUWC Ethics Committee, the following pre and postoperative data were collected from the chart: weight, height, body mass index (BMI), ultrasound (USG) of the abdomen, transaminases, lipid and metabolic profile. Results: Female, 62 years old, after liver transplant surgery, underwent vertical gastrectomy (Sleeve) in June 2019 for treatment of grade III obesity (BMI 40.1). Preoperative liver biopsy showed severe macrovesicular hepatic steatosis with USG compatible with severe steatosis and slightly elevated liver function tests. He evolved in the postoperative period without complications, being discharged in the 2nd PO. During outpatient follow-up, there was a loss of 24 kg in 5 months and USG control abdomen showed mild hepatic steatosis. Evidence of liver function, lipid and metabolic profile were within the normal range. Conclusions: Obesity is an important cause of orthotopic liver graft dysfunction. Bariatric surgery is a safe and effective therapy for the treatment of obesity and severe hepatic steatosis.