Affiliation:
1. Division of Gastroenterology, Hepatology, and Nutrition Department of Internal Medicine Ohio State University Wexner Medical Center Columbus Ohio USA
2. Division of Gastroenterology and Hepatology, Department of Internal Medicine Mayo Clinic Rochester Minnesota USA
3. Division of Biostatistics College of Public Health The Ohio State University Columbus Ohio USA
4. Department of Surgery Ohio State University Wexner Medical Center Columbus Ohio USA
5. Division of Gastroenterology Department of Internal Medicine University of California, Davis Sacramento California USA
Abstract
AbstractBackgroundObesity 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.MethodsUsing 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.ResultsOur 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.ConclusionDespite 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.