Nicholas P McKenna1,2, Elizabeth B Habermann3,4,5, Alaa Sada3,4, Todd A Kellogg6, Travis J McKenzie6. 1. Department of Surgery, Mayo Clinic, 200 1st Street SW, Rochester, MN, 55905, USA. mckenna.nicholas@mayo.edu. 2. The Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Surgical Outcomes Program, Mayo Clinic, Rochester, MN, USA. mckenna.nicholas@mayo.edu. 3. Department of Surgery, Mayo Clinic, 200 1st Street SW, Rochester, MN, 55905, USA. 4. The Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Surgical Outcomes Program, Mayo Clinic, Rochester, MN, USA. 5. Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA. 6. Division of Breast, Endocrine, Metabolic, and Gastrointestinal Surgery, Mayo Clinic, Rochester, MN, USA.
Abstract
BACKGROUND: The rate of obesity is rapidly increasing in patients with inflammatory bowel disease (IBD), but whether bariatric surgery in patients with IBD is safe and effective is not well understood. METHODS: A retrospective review of patients with IBD undergoing bariatric surgery across a multi-state health system was performed. Thirty-day postoperative outcomes, weight loss, and long-term complications were recorded. RESULTS: Thirty-one patients (81% female) with IBD and a mean preoperative body mass index (BMI) of 42.4 kg/m2 underwent 32 bariatric operations (n = 14 Roux-en-Y gastric bypass, n = 14 sleeve gastrectomy, n = 4 gastric band). Short-term infectious complications included superficial surgical site infection (n = 2), infected intra-abdominal hematoma (n = 1), and a hepatic abscess (n = 1). Percent excess weight loss was 57.2% (n = 25) at 6 months, 62.9% (n = 22) at 12 months, and 57.4% (n = 11) at 24 months. No IBD flares requiring surgery were observed at a median follow-up of 2.7 years (interquartile range, 0.8-4.2 years). CONCLUSION: In carefully selected patients with IBD, bariatric surgery appears safe with respect to short-term infectious complications and results in sustained weight loss until at least 2 years postoperatively.
BACKGROUND: The rate of obesity is rapidly increasing in patients with inflammatory bowel disease (IBD), but whether bariatric surgery in patients with IBD is safe and effective is not well understood. METHODS: A retrospective review of patients with IBD undergoing bariatric surgery across a multi-state health system was performed. Thirty-day postoperative outcomes, weight loss, and long-term complications were recorded. RESULTS: Thirty-one patients (81% female) with IBD and a mean preoperative body mass index (BMI) of 42.4 kg/m2 underwent 32 bariatric operations (n = 14 Roux-en-Y gastric bypass, n = 14 sleeve gastrectomy, n = 4 gastric band). Short-term infectious complications included superficial surgical site infection (n = 2), infected intra-abdominal hematoma (n = 1), and a hepatic abscess (n = 1). Percent excess weight loss was 57.2% (n = 25) at 6 months, 62.9% (n = 22) at 12 months, and 57.4% (n = 11) at 24 months. No IBD flares requiring surgery were observed at a median follow-up of 2.7 years (interquartile range, 0.8-4.2 years). CONCLUSION: In carefully selected patients with IBD, bariatric surgery appears safe with respect to short-term infectious complications and results in sustained weight loss until at least 2 years postoperatively.
Authors: Stephan C Bischoff; Rocco Barazzoni; Luca Busetto; Marjo Campmans-Kuijpers; Vincenzo Cardinale; Irit Chermesh; Ahad Eshraghian; Haluk Tarik Kani; Wafaa Khannoussi; Laurence Lacaze; Miguel Léon-Sanz; Juan M Mendive; Michael W Müller; Johann Ockenga; Frank Tacke; Anders Thorell; Darija Vranesic Bender; Arved Weimann; Cristina Cuerda Journal: United European Gastroenterol J Date: 2022-08-12 Impact factor: 6.866