Jon S Thompson1, Rebecca A Weseman2, Fedja A Rochling3, Wendy J Grant2, Jean F Botha2, Alan N Langnas2, David F Mercer2. 1. Department of Surgery, University of Nebraska Medical Center Omaha, Omaha, NE, USA. Electronic address: jthompso@unmc.edu. 2. Department of Surgery, University of Nebraska Medical Center Omaha, Omaha, NE, USA. 3. Department of Internal Medicine, University of Nebraska Medical Center Omaha, Omaha, NE, USA.
Abstract
BACKGROUND: Obese patients developing short bowel syndrome (SBS) maintain a higher body mass index (BMI) and have increased risk of hepatobiliary complications. Our aim was to determine the effect of pre-resection gastric bypass (GBP) on SBS outcome. METHODS: We reviewed 136 adults with SBS: 69 patients with initial BMI < 35 were controls; 43 patients with BMI > 35 were the obese group; and 24 patients had undergone GBP before SBS. RESULTS: BMI at 1, 2, and 5 years was similar in control and GBP groups, whereas obese patients had a persistently increased BMI. Eight (33%) of the GBP patients had a pre-resection BMI > 35, but post-SBS BMI was similar to those <35. Obese patients were more likely to wean off PN (47% vs 20% control and 12% GBP, P < .05). Radiographic fatty liver tended to be higher in the GBP group (54% vs 19% control and 35% obese). End-stage liver disease occurred more frequently in obese and GBP patients (30% and 33% vs 13%, P < .05). CONCLUSIONS: Pre-resection GBP prevents the nutritional benefits of obesity but does not eliminate the increased risk of hepatobiliary disease in obese SBS patients. This occurs independent of pre-SBS BMI suggesting the importance of GBP itself or history of obesity rather than weight loss.
BACKGROUND:Obesepatients developing short bowel syndrome (SBS) maintain a higher body mass index (BMI) and have increased risk of hepatobiliary complications. Our aim was to determine the effect of pre-resection gastric bypass (GBP) on SBS outcome. METHODS: We reviewed 136 adults with SBS: 69 patients with initial BMI < 35 were controls; 43 patients with BMI > 35 were the obese group; and 24 patients had undergone GBP before SBS. RESULTS: BMI at 1, 2, and 5 years was similar in control and GBP groups, whereas obesepatients had a persistently increased BMI. Eight (33%) of the GBP patients had a pre-resection BMI > 35, but post-SBS BMI was similar to those <35. Obesepatients were more likely to wean off PN (47% vs 20% control and 12% GBP, P < .05). Radiographic fatty liver tended to be higher in the GBP group (54% vs 19% control and 35% obese). End-stage liver disease occurred more frequently in obese and GBP patients (30% and 33% vs 13%, P < .05). CONCLUSIONS: Pre-resection GBP prevents the nutritional benefits of obesity but does not eliminate the increased risk of hepatobiliary disease in obese SBSpatients. This occurs independent of pre-SBS BMI suggesting the importance of GBP itself or history of obesity rather than weight loss.
Authors: Neesha S Patel; Ujwal R Yanala; Shruthishree Aravind; Roger D Reidelberger; Jon S Thompson; Mark A Carlson Journal: Sci Rep Date: 2021-06-21 Impact factor: 4.996
Authors: Ujwal R Yanala; Roger D Reidelberger; Jon S Thompson; Valerie K Shostrom; Mark A Carlson Journal: Sci Rep Date: 2015-11-27 Impact factor: 4.379