Impact of Metabolic Surgery on the Severity and Outcomes of Acute Pancreatitis: A Retrospective Matched Cohort Study
- PMID: 40804224
- DOI: 10.1007/s11695-025-08167-y
Impact of Metabolic Surgery on the Severity and Outcomes of Acute Pancreatitis: A Retrospective Matched Cohort Study
Abstract
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.
Keywords: Acute pancreatitis; Bariatric surgery; Biliopancreatic diversion; Obesity; Roux-en-Y gastric bypass.
© 2025. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.
Conflict of interest statement
Declarations. Competing interests: The authors disclose the following financial relationships: Dr. Vitor Ottoboni Brunaldi has received honoraria from Erbe Elektromedizin GMHB for lectures and testimonies. Dr. Andrew Storm has received research grants from Apollo Endosurgery, Boston Scientific, Endogenex, Endo-TAGSS, Enterasense, EnVision, OnePass, and SofTac. He has also served as a consultant for Boston Scientific, Cook, Olympus, Intuitive, and Medtronic. Dr. Vinay Chandrasekhara has received research support from STARmed and has served as a consultant for Boston Scientific. Dr. Ryan Law has received research support and served as a consultant for Olympus and Boston Scientific. He also receives royalties from UpToDate. Dr. Omar M. Ghanem is a consultant for Medtronic and Olympus. Dr. Barham K. Abu Dayyeh has received consulting and research support from Boston Scientific, Medtronic, Apollo Endosurgery, and EndoGastric Solutions (now Merit Medical). He has served as a consultant for Olympus and BFKW, and received research support from USGI Medical. He is also a co-inventor of Endogenex, licensed by Mayo Clinic. All other authors have no financial relationships or conflicts of interest to disclose relevant to this manuscript.
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