The prevalence of non-alcoholic fatty liver disease (NAFLD) and non-alcoholic steatohepatitis (NASH) has considerably increased over the last years. NAFLD is currently the most common cause of chronic liver disease in the developing world. The diagnosis of NAFLD/NASH is often incidental, as the early-stage of disease is frequently free of symptoms. Most patients recognized with NAFLD have severe obesity and other obesity-related disease such as type 2 diabetes mellitus (T2DM), insulin-resistance, dyslipidemia and hypertension. The only proven method for NAFLD improvement and resolution is weight loss. Bariatric surgery leads to significant and long-term weight loss as well as improvement of coexisting diseases. There is a lot of evidence suggesting that metabolic/bariatric surgery is an effective method of NAFLD treatment that leads to reduction in steatosis, hepatic inflammation and fibrosis. However, there is still a need to perform long-term studies in order to determine the role of bariatric surgery as a treatment option for NAFLD and NASH. This review discusses current evidence about epidemiology, pathogenesis and treatment options for NAFLD including bariatric/metabolic surgery and its effect on improvement and resolution of NAFLD.

Background: Although laparoscopic sleeve gastrectomy (LSG) is considered a safe bariatric procedure in the treatment of obesity, it still involves a risk of developing postoperative complications. Knowledge of risk factors for possible complications would allow appropriate preoperative planning, optimization of postoperative care, as well as early diagnosis and treatment. The aim of this study was to evaluate risk factors for complications after laparoscopic sleeve gastrectomy. Methods: A retrospective study of 610 patients who underwent LSG at a tertiary institution were included in the study through retrospective analysis of the medical data. Complications were categorized as early (<30 days) and late (≥30 days) and evaluated according to the Clavien–Dindo Classification. Results: Early complications were observed in 35 patients (5.74%) and late complications occurred in 10 patients (1.64%). Independent risk factors of early complications after laparoscopic sleeve gastrectomy included hypercholesterolemia (OR 3.73; p-value = 0.023) and smoking (OR = 274.66, p-value < 0.001). Other factors that may influence the postoperative course are length of hospital stay and operation time. Smoking, peptic ulcer diseases and co-existence of hiatal hernia were found to be an independent predictors of late complications. Conclusions: Smoking is associated with the higher risk of both, early and late complications, while hypercholesterolemia with only <30 days complications after laparoscopic sleeve gastrectomy.

Background: Morbid obesity co-exists with non-alcoholic fatty liver disease in up to 90% of cases. Laparoscopic sleeve gastrectomy leads to a reduction in body mass and thus may improve the course of non-alcoholic fatty liver disease. The aim of this study was to evaluate the effect of laparoscopic sleeve gastrectomy on the resolution of non-alcoholic fatty liver disease. Methods: The study included 55 patients with non-alcoholic fatty liver disease who underwent laparoscopic sleeve gastrectomy at a tertiary institution. The analysis consisted of preoperative liver biopsy, abdominal ultrasound, weight loss parameters, Non-Alcoholic Fatty Liver Fibrosis Score and selected laboratory parameters. Results: Before the surgery, 6 patients were diagnosed with grade 1 liver steatosis, 33 patients with grade 2 and 16 patients with grade 3. One year after the surgery, only 21 patients had features of liver steatosis at ultrasound. All weight loss parameters showed statistically significant changes during the observation; the median percentage of total weight loss was 31.0% (IQR: 27.5; 34.5) with p = 0.0003, the median percentage of excess weight loss was 61.8% (IQR: 52.4; 72.3) with p = 0.0013 and the median percentage of excess body mass index loss was 71.0% (IQR: 61.3; 86.9) with p = 0.0036 12 months after laparoscopic sleeve gastrectomy. The median Non-Alcoholic Fatty Liver Fibrosis Score at baseline was 0.2 (IQR: −0.8; 1.0) and decreased to −1.6 (IQR: −2.4; −0.4) (p < 0.0001). Moderate negative correlations between Non-Alcoholic Fatty Liver Fibrosis Score and percentage of total weight loss (r = −0.434, p < 0.0001), percentage of excess weight loss (r = −0.456, p < 0.0001) and percentage of excess body mass index loss (r = −0.512, p < 0.0001) were found. Conclusions: The study supports the thesis that laparoscopic sleeve gastrectomy is an effective method for treatment of non-alcoholic fatty liver disease in patients with morbid obesity.

Background: Bariatric surgery is an effective treatment for obesity, leading to significant weight loss and improvements in metabolic health. However, massive weight loss often results in excess skin, which can negatively impact body image, psychological well-being, and quality of life. Abdominoplasty is commonly performed after bariatric surgery to address these concerns. Our study aimed to evaluate the effects of post-bariatric abdominoplasty on psychological well-being, body image, social relationships, and sexual functioning in formerly obese patients. Methods: A single-center, cross-sectional recall study was conducted on 35 patients, out of 135 invited, who underwent sleeve gastrectomy followed by abdominoplasty 12–24 months after the initial surgery. Participants completed validated questionnaires assessing psychological well-being, depression, anxiety, self-esteem, body perception, social relationships, and sexual functioning. Pairwise comparisons were performed to assess changes across the preoperative, post-bariatric, and post-abdominoplasty stages. Results: Psychological well-being significantly improved post-bariatric surgery, with further reductions in anxiety and depressive symptoms after abdominoplasty. However, body shape perception and self-esteem improved after bariatric surgery but did not show additional enhancement following abdominoplasty. Social support remained largely unchanged, except for modest improvements in attachment and reliable alliance. Sexual functioning improved significantly after bariatric surgery but showed no further significant gains after abdominoplasty. Conclusions: While abdominoplasty is associated with additional psychological benefits, particularly in reducing anxiety and depressive symptoms, it does not significantly enhance body perception, self-esteem, or sexual functioning beyond the effects of bariatric surgery. These findings highlight the importance of setting realistic patient expectations regarding the benefits of body contouring surgery in post-bariatric care.

Introduction: The fear of SARS-CoV-2 infection had a significant impact on number of patients reporting to the hospitals. Despite the presence of disturbing symptoms, patients postponed their medical visits. It resulted in health deterioration that worsened conditions for surgical procedures. Aim: The aim of study was to analyze the impact of COVID-19 pandemic on number of patients reporting to the Emergency Department at University Hospital in Bialystok and number of surgical emergency procedures and the Department of General Surgery. Material and methods: The retrospective analysis of patients who reported to Internal Medicine and Surgical office of the Emergency Department at University Hospital in Białystok in the same periods from June to December 2019 and 2020 with surgical conditions such as: cholecystitis, inguinal hernia and umbilical hernia. Results: In 2020, there was a significant decrease in number of patients reporting to the Emergency Department when compared to 2019 (664 vs. 955). In 2020, there were more emergency surgeries performed including laparoscopic cholecystectomy (32 vs. 28) and inguinal hernia repair (17 vs. 5, p=0.0013) comparing to 2019. The analysis of biochemical parameters showed higher level od C-reactive protein in patients undergoing emergency surgery in 2020 when compared to 2019 (11.85 vs. 3.35 p=0.0140). Conclusion: The number of patients reporting to the Emergency Department was significantly lower in 2020 when compared to 2019 and patients presented more severe symptoms and general condition. The above analysis triggered by the Coronovirus pandemic could be a useful tool for better managing similar crisis in the future. Introduction: The fear of SARS-CoV-2 infection had a significant impact on number of patients reporting to the hospitals. Despite the presence of disturbing symptoms, patients postponed their medical visits. It resulted in health deterioration that worsened conditions for surgical procedures. Aim: The aim of study was to analyze the impact of COVID-19 pandemic on number of patients reporting to the Emergency Department at University Hospital in Bialystok and number of surgical emergency procedures and the Department of General Surgery. Material and methods: The retrospective analysis of patients who reported to Internal Medicine and Surgical office of the Emergency Department at University Hospital in Białystok in the same periods from June to December 2019 and 2020 with surgical conditions such as: cholecystitis, inguinal hernia and umbilical hernia. Results: In 2020, there was a significant decrease in number of patients reporting to the Emergency Department when compared to 2019 (664 vs. 955). In 2020, there were more emergency surgeries performed including laparoscopic cholecystectomy (32 vs. 28) and inguinal hernia repair (17 vs. 5, p=0.0013) comparing to 2019. The analysis of biochemical parameters showed higher level od C-reactive protein in patients undergoing emergency surgery in 2020 when compared to 2019 (11.85 vs. 3.35 p=0.0140). Conclusion: The number of patients reporting to the Emergency Department was significantly lower in 2020 when compared to 2019 and patients presented more severe symptoms and general condition. The above analysis triggered by the Coronovirus pandemic could be a useful tool for better managing similar crisis in the future.

Background/Objectives: Metabolic syndrome, defined by the coexistence of central obesity, dyslipidemia, hypertension, and insulin resistance, is a significant contributor to increased cardiovascular morbidity and mortality in the aging population. We aimed to determine whether age influences the efficacy of LSG in treating obesity-related comorbidities. Methods: A retrospective analysis of lipid profiles, glycemic and clinical parameters was conducted in a group of 786 patients in two age groups (under 50 years old and over 50 years old) who underwent laparoscopic sleeve gastrectomy with follow-ups 1, 3, 6, 12 and 24 months after surgery. Results: There was a significant improvement in lipid metabolism with no significant differences between the two age groups in these parameters throughout the observation period. Furthermore, there was significant weight loss (54.82 kg vs. 54.56 kg) and BMI reductions (47.71 kg/m² vs. 47.01 kg/m² to 29.03 kg/m² vs. 30.73 kg/m²). Total cholesterol decreased from 198 mg/dL to 184.9 mg/dL (50 years old). LDL dropped from 136.2 mg/dL to 116.7 mg/dL and from 141.0 mg/dL to 121.0 mg/dL. Mean HbA1c decreased to comparable levels (5.66% vs. 5.53%). Both groups showed similar rates of remission for type 2 diabetes and hypertension. Conclusions: Our findings suggest that LSG is an effective method for treating components of metabolic syndrome regardless of age, supporting its use as a therapeutic tool for older patients.