Pre-resection gastric bypass reduces post-resection body mass index but not liver disease in short bowel syndrome

Jon S. Thompson, Rebecca A. Weseman, Fedja A. Rochling, Wendy J. Grant, Jean F. Botha, Alan N. Langnas, David F. Mercer

Research output: Contribution to journalArticle

2 Scopus citations

Abstract

BACKGROUND: Obese patients developing short bowel syndrome (SBS) maintain a higher body mass index (BMI) and have increased risk of hepatobiliary complications. Our aim was to determine the effect of pre-resection gastric bypass (GBP) on SBS outcome. METHODS: We reviewed 136 adults with SBS: 69 patients with initial BMI < 35 were controls; 43 patients with BMI > 35 were the obese group; and 24 patients had undergone GBP before SBS. RESULTS: BMI at 1, 2, and 5 years was similar in control and GBP groups, whereas obese patients had a persistently increased BMI. Eight (33%) of the GBP patients had a pre-resection BMI > 35, but post-SBS BMI was similar to those <35. Obese patients were more likely to wean off PN (47% vs 20% control and 12% GBP, P <.05). Radiographic fatty liver tended to be higher in the GBP group (54% vs 19% control and 35% obese). End-stage liver disease occurred more frequently in obese and GBP patients (30% and 33% vs 13%, P <.05). CONCLUSIONS: Pre-resection GBP prevents the nutritional benefits of obesity but does not eliminate the increased risk of hepatobiliary disease in obese SBS patients. This occurs independent of pre-SBS BMI suggesting the importance of GBP itself or history of obesity rather than weight loss.

Original languageEnglish (US)
Pages (from-to)942-948
Number of pages7
JournalAmerican journal of surgery
Volume207
Issue number6
DOIs
StatePublished - Jun 2014

Keywords

  • Gastric bypass
  • Liver disease
  • Obesity
  • Short bowel syndrome

ASJC Scopus subject areas

  • Surgery

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