PREVALENCE OF ACUTE PANCREATITIS IS INCREASED AMONG PATIENTS WHO UNDERWENT BARIATRIC SURGERY: A NATIONWIDE POPULATION-BASED STUDY
Ahmed Eltelbany*, Osama Hamid, Abdul Mohammed, Khaled Alsabbagh Alchirazi, Sushrut Trakroo, Madhusudhan R. Sanaka, Prashanthi N. Thota
Cleveland Clinic, Lakewood, OH
Background & Aims: Patients who increasingly undergoing bariatric surgery however the long term risk of acute pancreatitis (AP) following bariatric surgery is not well known in the literature with smaller single institution studies reporting a prevalence rate around 1%. We sought to investigate the prevalence of acute pancreatitis in patients who underwent bariatric surgery in a large population based study.
Methods: We used a commercial database (Explorys Inc, Cleveland, OH) which includes electronic health record data from 26 major integrated US healthcare systems. Based on Systematized Nomenclature Of Medicine – Clinical Terms (SNOMED-CT), we identified all patients (age >18 years) who underwent any type of bariatric surgery including sleeve gastroplasty and Roux-en-Y surgery. We investigated the prevalence of acute pancreatitis. Logistic regression analysis was performed for AP in 2 groups of patients: those who underwent bariatric surgery and those who did not.
Results: Of the 60,155,250 individuals in the database from 1999 to present, we identified 43,860 (0.073%) patients who underwent sleeve gastroplasty and 151,190 (0.25%) patients who underwent Roux-en-Y gastric bypass surgery, of whom 440 (1.00%) and 1,980 (1.31%) patients developed acute pancreatitis post-operatively, respectively. Furthermore, we identified 59,960,200 who did not undergo bariatric surgery of which 380,870 (0.64%) developed acute pancreatitis. Both patients who underwent sleeve gastroplasty and Roux-en-Y gastric bypass surgery had significantly higher odds of developing acute pancreatitis with an odds ratio of 1.58 (CI 1.44 – 1.74, p < 0.0001) and 2.08 (1.99 – 2.17, p < 0.0001), respectively.
Conclusion: This is the largest individual study utilizing a population-based approach and is consistent with the results of smaller cohort studies. The results indicate that patients who underwent bariatric surgery are at an increased risk of AP particularly patients who underwent Roux-en-Y gastric bypass surgery.
Baseline characteristics of patients with and without history of bariatric surgery
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