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Vertical sleeve gastrectomy linked to higher postsurgery acute pancreatitis risk

12 Oct 2018

Vertical sleeve gastrectomy (VSG) confers a higher risk of acute pancreatitis (AP) than Roux-en-Y gastric bypass surgery (RYGB), particularly in young patients and in those with gallstones, reports a recent study.

Drawing from the National Readmission Database of the USA, researchers compared the rates of AP within 6 months before and after surgery among morbidly obese participants who underwent VSG (n=205,251), RYGB (169,973) or hernia repair (HR; controls; n=16,845). Each group was further divided into pre- and postsurgery cohorts, depending on the timing of patient discharge.

Presurgery AP was highest in the HR group (0.17 percent), while postsurgery AP was most prevalent in patients who received VSG (0.21 percent). More than half (58.3 percent) of AP readmission occurred within 30 days after VSG.

After complete adjustments for confounding variables such as age, sex and comorbidities, weighted logistic regression analysis showed that the risk of post- vs presurgery AP was highest in patients who received AP (adjusted odds ratio [OR], 5.16; 95 percent CI, 3.11–8.56; p<0.001).

The post- vs presurgery AP risk associated with RYGB was also significantly elevated, but to a lesser degree (adjusted OR, 2.26; 1.33–3.87; p=0.003). No increase in AP risk following HR was observed.

Moreover, when researchers compared the types of surgery with each other, they showed that VSG resulted in a significantly higher post- vs presurgery AP risk than RYGB (adjusted OR, 2.28; 1.10–4.73; p=0.03) and HR (adjusted OR, 7.58; 2.09–27.58; p=0.002). There was no significant difference between RYGB and HR (adjusted OR, 3.33; 0.91–12.18; p=0.07).

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Parenteral methotrexate is not better than placebo at maintaining a steroid-free response or preventing relapse in patients with mild-to-moderate ulcerative colitis (UC), a recent study has shown.