EUS Guided Core Liver Biopsy and IGB Placement for the Diagnosis and Management of NASH and Obesity

Combined Endoscopic Ultrasound Guided Core Liver Biopsy and Intragastric Balloon Placement for the Diagnosis and Management of Nonalcoholic Steatohepatitis and Obesity

This study is designed to investigate the impact of weight loss achieved with the IGB on NASH with early fibrosis in a select cohort of patients with obesity preselected to have a high pre-test probability of having NASH with early fibrosis based on magnetic resonance elastography (MRE)-Hepatogram. In addition, this study will explore potential non-invasive imaging criteria for NASH and early fibrosis using EUS-Elastography.

Inclusion Criteria:

• Patients diagnosed with Non-alcoholic Steatohepatitis with early evidence of fibrosis as seen on MRE-hepatogram
• Referred clinically for an intragastric balloon placement for weight loss

Exclusion Criteria:

• Women who are pregnant or plan to be pregnant or are breastfeeding
• Previous history of gastric surgery
• Current or recent (within 6 months) gastric or duodenal ulcers
• Gastroparesis
• Liver cirrhosis
• Coagulopathy or active use of coagulation
• Inability to provide a written informed consent