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Outcomes of bariatric surgery for patients with prevalent inflammatory bowel disease: A nationwide registry-based cohort study
Department of Surgery, Faculty of Medicine and Health, Örebro University, Sweden.
Örebro University, School of Medical Sciences. Örebro University Hospital. Department of Surgery.
Örebro University, School of Medical Sciences. Örebro University Hospital. Clinical Epidemiology and Biostatistics.ORCID iD: 0000-0002-3552-9153
Department of Biomedical and Clinical Sciences, Linköping University and Department of Surgery, Vrinnevi, Norrköping, Sweden.
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2023 (English)In: Surgery, ISSN 0039-6060, E-ISSN 1532-7361, Vol. 174, no 2, p. 144-151Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: Obesity is becoming more prevalent in patients with inflammatory bowel disease. Although bariatric surgery is an effective treatment for obesity, questions remain regarding its safety and effectiveness for patients with inflammatory bowel disease. The aim of this study was to evaluate the safety and effectiveness of bariatric surgery in patients with inflammatory bowel disease.

METHOD: This registry-based, propensity-matched cohort study included all patients who had primary Roux-en-Y gastric bypass or sleeve gastrectomy in Sweden from January 2007 to June 2020 who had an inflammatory bowel disease diagnosis and matched control patients without an inflammatory bowel disease diagnosis. The study included data from the Scandinavian Obesity Surgery Registry, the National Patient Register, the Swedish Prescribed Drugs Register, the Total Population Register, and the Education Register from Statistics Sweden.

RESULTS: In total, 71,093 patients who underwent bariatric surgery, including 194 with Crohn's disease and 306 with ulcerative colitis, were 1:5 matched to non-inflammatory bowel disease control patients. The patients with Crohn's disease had a higher readmission rate within 30 days (10.7% vs 6.1%, odds ratio = 1.84, 95% confidence interval 1.02-3.31) than the control patients, with no significant difference between the surgical methods. The patients with ulcerative colitis had a higher risk for serious postoperative complications after Roux-en-Y gastric bypass (8.0% vs 3.7%, odds ratio = 2.64, 95% confidence interval 1.15-6.05) but not after sleeve gastrectomy compared to control patients (0.8% vs 2.3%). No difference was observed in postoperative weight loss or postoperative health-related quality of life.

CONCLUSION: Sleeve gastrectomy appears to be a safe and effective treatment for obesity in patients with inflammatory bowel disease, whereas Roux-en-Y gastric bypass was associated with a higher risk for postoperative complications in patients with ulcerative colitis.

Place, publisher, year, edition, pages
Elsevier, 2023. Vol. 174, no 2, p. 144-151
National Category
Gastroenterology and Hepatology
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URN: urn:nbn:se:oru:diva-106170DOI: 10.1016/j.surg.2023.04.059ISI: 001050743000001PubMedID: 37263879Scopus ID: 2-s2.0-85160511654OAI: oai:DiVA.org:oru-106170DiVA, id: diva2:1762127
Available from: 2023-06-02 Created: 2023-06-02 Last updated: 2023-09-06Bibliographically approved

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Ottosson, JohanCao, YangBergemalm, DanielEriksson, CarlSzabo, EvaStenberg, Erik

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