Impact of Endoscopic Sleeve Gastroplasty in Non-alcoholic Fatty Liver Disease: a Systematic Review and Meta-analysis

Non-alcoholic fatty liver disease (NAFLD) is the most common cause of liver disease worldwide. Endoscopic sleeve gastroplasty (ESG) has proven to be feasible, safe, and effective in the management of obesity. We performed the first systematic review and meta-analysis evaluating NAFLD and other metabolic parameters 12 months post-ESG. Four observational studies with a total of 175 patients were included. The results showed a significant ( p < 0.05) reduction of 4.85 in hepatic steatosis index (95% CI − 6.02, − 3.67), 0.5 in NAFLD fibrosis score (95% CI − 0.80, − 0.19), 6.32 U/l in ALT (95% CI − 9.52, − 3.11), 17.28% in TWL (95% CI − 18.24, − 16.31), 6.31 kg/m 2 in BMI (95% CI − 8.11, − 4.52), 47.97% in EWL (95% CI − 49.10, − 46.84), and 0.51% in HbA1c (95% CI − 0.90, − 0.12). ESG improves liver parameters, provides weight loss, and reduces HbA1c levels in patients suffering from NAFLD. Graphical Abstract