New Research Says Bariatric Surgery May Not Worsen Acute Pancreatitis Outcomes

Generally those who embark on weight loss surgery have an increased risk of gallstones, and in turn, a risk of developing pancreatitis. However, according to new researchers, the subset of patients with acute pancreatitis have no greater risk for mortality from this health condition and even have shorter hospital stays and use fewer health care resources overall.
Bariatric surgery is becoming more and more increasingly common. While patients do have a higher risk of gallstones, there are no large-scale major studies in the United States or worldwide showing the association between acute pancreatitis and prior bariatric surgery, Somashekar Krishna, MD, MPH, assistant professor in the Department of Gastroenterology, Hepatology and Nutrition at The Ohio State University Medical Center, said. Krishna and his colleagues presented their findings at the 2014 meeting of the American College of Gastroenterology on the topic.

About the Research

The researchers of this study consulted within the Nationwide Inpatient Sample for 2007-2011 and used diagnostic codes in order to identify various patients admitted with the diagnosis of acute pancreatitis as well as those who had bariatric surgery and had the same diagnosis. This sample was also used in order to compare the causes of the condition, hospital factors, demographics, complications, mortality, and length of stay.

The study also found an increase in the admissions for acute pancreatitis and the number of patients who had weight loss surgery. In fact, they report that the number doubled during a five-year period of time.

During the study period, 1.35 million patients were admitted for the conditions and the number of patients who also had weight loss surgery went from .73% to 1.39%. They found that the majority of patients who had weight loss surgery with the condition were young females with private insurance. Krishna also reports that they had more frequent gallstones and more incidents of gallbladder removal surgeries. According to Krishna, researchers observed patients who had more frequent non-endoscopic biliary access compared to a control group.

Ultimately after much analysis by the research group, they found no direct association between weight loss surgery and an increased mortality rate. “The linear regression analysis showed they had a shorter LOS and incurred fewer hospital charges,” Dr. Krishna said. These research findings were strengthened by a matched analysis of nearly 3,000 matched pairs of patients whose information also concluded the same findings. The researchers believe that a possible explanation for the association between bariatric surgery and better outcomes with acute pancreatitis has to do directly with the effect of inflammation in the body post-surgery.

It’s no secret that obesity drives inflammation up in the body. There is some evidence showing that those with weight loss after surgery do have a decreased in many proinflammatory factors. Whether this is the reason for better outcomes with acute pancreatitis remains to be determined, Krishna said.