Impact of Metabolic Surgery on the Severity and Outcomes of Acute Pancreatitis: A Retrospective Matched Cohort Study.

BACKGROUND

Patients with a history of Metabolic and Bariatric Surgery (MBS) face an increased risk of acute pancreatitis (AP) due to factors like rapid weight loss and altered gastrointestinal anatomy. However, data on the severity and outcomes of AP in these patients are limited. This study evaluates whether a history of MBS, particularly Roux-en-Y gastric bypass (RYGB) and biliopancreatic diversion with duodenal switch (BPD/DS), affects the severity and clinical outcomes of AP.

METHODS

This retrospective matched cohort study included patients admitted with AP to Mayo Clinic between 2013 and 2022. Patients with a history of RYGB or BPD/DS were matched to two control groups without prior bariatric surgery: (1) BMI-matched controls (± 1 kg/m2), and (2) higher-BMI controls (≥ 5 kg/m2 higher). The primary outcome was AP severity, and secondary outcomes included local complications, hospital length of stay, recurrence, and 30-day readmission.

RESULTS

Compared to the higher-BMI control group, the MBS group had lower rates of severe AP (0% vs. 26.3%, p < 0.001), fewer local complications (10.5% vs. 57.9%, p < 0.001), shorter hospital stays (median 3 vs. 10 days, p = 0.044), and fewer AP recurrences at 6 months (21.1% vs. 50%, p = 0.045). No significant differences were found between the MBS and BMI-matched groups.

CONCLUSION

MBS, including RYGB and BPD/DS, does not worsen AP severity or outcomes and may improve them, possibly through weight loss and reduced comorbid conditions. Further studies are needed to confirm these findings in larger, diverse populations.