The impact of bariatric surgery on admissions for gastrointestinal complications and conditions associated with obesity: A nationwide study.
World J Surg
; 48(1): 175-185, 2024 01.
Article
em En
| MEDLINE
| ID: mdl-38436211
ABSTRACT
BACKGROUND:
Obesity worsens various gastrointestinal pathologies. While bariatric surgery ameliorates obesity, it substantially modifies the gastrointestinal system depending on surgery type, with limited data on subsequent impact on obesity-related gastrointestinal admissions.METHODS:
Using the 2012-2014 Nationwide Readmission Database, we included individuals with obesity who received vertical sleeve gastrectomy (VSG), Roux-en-Y gastric bypass (RYGB), or hernia repair (HR-control surgery). Our main focus was the adjusted odds ratio (aOR) for gastrointestinal inpatient admissions within 6 months following surgery compared to the 6 months preceding it, while controlling for several confounding factors. Gastrointestinal admissions were grouped into postoperative complications or obesity-associated gastrointestinal conditions.RESULTS:
Our cohort included 140,103 adults with RYGB, 132,253 with VSG, and 12,436 HR controls. Postoperative gastrointestinal complications were most common after RYGB, prominently obstruction (aOR = 33.17, 95%CI 18.01, 61.10), and Clostridium difficile infection (aOR 12.52, 95%CI 6.22, 25.19). VSG also saw significantly increased but less frequent similar conditions. Notably, for gastrointestinal conditions associated with obesity, acute pancreatitis risk was higher post-VSG (aOR = 6.26, 95%CI 4.02, 9.73). Post-RYGB patients were most likely to be admitted for cholelithiasis with cholecystitis (aOR 4.15, 95% CI 3.24, 5.31), followed by chronic liver disease (aOR 3.00, 95% CI 2.33, 3.87). The risk of noninfectious colitis admissions was threefold higher after RYGB and VSG. No gastrointestinal conditions showed an increase after HR.CONCLUSION:
Despite weight loss, bariatric surgery was associated with an increased risk of hepato-pancreatobiliary and colitis admissions related to obesity in the first six postoperative months, with considerable variations in rates of gastrointestinal conditions by surgery type.Palavras-chave
Texto completo:
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Base de dados:
MEDLINE
Assunto principal:
Pancreatite
/
Colite
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Cirurgia Bariátrica
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Gastroenteropatias
Limite:
Adult
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Humans
Idioma:
En
Ano de publicação:
2024
Tipo de documento:
Article