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©The Author(s) 2025. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Pharmacol Ther. Dec 5, 2025; 16(4): 111074
Published online Dec 5, 2025. doi: 10.4292/wjgpt.v16.i4.111074
Published online Dec 5, 2025. doi: 10.4292/wjgpt.v16.i4.111074
Endoscopic sleeve gastrectomy vs traditional bariatric surgery: A paradigm shift in managing metabolic dysfunction-associated steatohepatitis and cirrhosis?
David Jerez Diaz, Internal Medicine, Florida State University, Sarasota Memorial Hospital, Sarasota, FL 34239, United States
Rishi Devaraja Vattikuti, Internal Medicine, University of Pittsburgh Medical Center, Pittsburgh, PA 15219, United States
Allison Janak, Anuroop Yekula, Asad Ullah, Truptesh H Kothari, Shivangi Kothari, Vivek Kaul, Patrick Twohig, Department of Gastroenterology and Hepatology, University of Rochester Medical Center, Rochester, NY 14682, United States
Priya Farooq, Department of Transplant Hepatology, University of Rochester Medical Center, Rochester, NY 14682, United States
Author contributions: Janak A, Vattikuti RD, Yekula A, Jerez Diaz D, Farooq P, Ullah A, Kothari TH, Kothari S, Kaul V, and Twohig P contributed to this work; Twohig P designed the study concepts and outline; Janak A, Vattikuti RD, Yekula A, Jerez Diaz D conducted the literature review and drafted the manuscript; Jerez Diaz D, Farooq P, Ullah A, Kothari TH, Kothari S, Kaul V, and Twohig P made critical revisions; all authors prepared the draft and approved the submitted version.
Conflict-of-interest statement: The authors declare no conflict of interests for this article.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Patrick Twohig, MD, Assistant Professor, FRCPC, Department of Gast
Received: June 23, 2025
Revised: July 30, 2025
Accepted: November 7, 2025
Published online: December 5, 2025
Processing time: 166 Days and 7.1 Hours
Revised: July 30, 2025
Accepted: November 7, 2025
Published online: December 5, 2025
Processing time: 166 Days and 7.1 Hours
Core Tip
Core Tip: Endoscopic sleeve gastroplasty (ESG) is an emerging minimally invasive option for obesity and metabolic dysfunction-associated steatohepatitis (MASH), particularly in patients with advanced liver disease who are poor surgical candidates. This review explores ESG’s potential to improve weight loss, insulin resistance, and hepatic markers, with fewer complications than traditional bariatric surgery, though current evidence remains preliminary. As the global burden of MASH grows, ESG may represent a safer, more accessible intervention, especially where liver transplantation is not feasible, while ongoing trials and individualized strategies continue to clarify its long-term role in liver care.