Enhanced long-term outcomes with laparoscopic bariatric surgery in patients with severe obesity and metabolic dysfunction-associated steatotic liver disease: a retrospective cohort study

Background: Bariatric surgery is a potential treatment for weight loss in patients with metabolic dysfunction-associated steatotic liver disease (MASLD) and severe obesity. However, the impact of bariatric surgery types on long-term outcomes and healthcare utilization in this population has not been well characterized. We aimed to compare long-term outcomes and healthcare utilization between laparoscopic and open bariatric surgery in patients with MASLD and severe obesity. Methods: Research Databases, with patient baseline characteristics in the two study arms balanced via propensity score matching (PSM). The primary outcomes were liver and non-liver outcomes including cardiovascular disease (CVD), chronic kidney disease (CKD), and obesity-related cancers. Results: $24,353, P<0.001) annually than those with open surgery. Conclusions: Laparoscopic surgery is a promising potential treatment for patients with MASLD and severe obesity with more favorable long-term outcomes and healthcare utilization and costs than open surgery. Randomized clinical trials and additional cost-effectiveness analysis are needed to corroborate the findings.