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 Norman Langnas, David F Mercer

Research output: Contribution to journalArticle

2 Citations (Scopus)

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

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Short Bowel Syndrome
Gastric Bypass
Liver Diseases
Body Mass Index
Obesity
End Stage Liver Disease
Fatty Liver
Weight Loss

Keywords

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

ASJC Scopus subject areas

  • Surgery

Cite this

Pre-resection gastric bypass reduces post-resection body mass index but not liver disease in short bowel syndrome. / Thompson, Jon S; Weseman, Rebecca A.; Rochling, Fedja A; Grant, Wendy J.; Botha, Jean F.; Langnas, Alan Norman; Mercer, David F.

In: American journal of surgery, Vol. 207, No. 6, 06.2014, p. 942-948.

Research output: Contribution to journalArticle

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