Background

Bariatric surgery has been reported to produce durable weight loss, with sleeve gastrectomy (SG) being the most common procedure. Although obesity is a common comorbidity of inflammatory bowel disease (IBD), the impact of IBD on short-term bariatric surgery outcomes has not been widely reported. This study assessed whether IBD was associated with adverse post-SG outcomes.

Methods

We identified SG using the 2010-2019 Nationwide Readmissions Database (NRD) and stratified by diagnosis of IBD. The SG cohort was propensity matched based on age, biological sex, body mass index, comorbidity burden, and discharge month. Primary outcomes included in-hospital mortality, post-operative complications (composite of nausea, bowel obstruction, gallstones, incisional hernia, blood-loss anemia, ulceration, organ, hemorrhage, and infection), and all-cause 90-day readmission. Secondary outcomes included length of stay (LOS) and total hospital cost.

Results

A total of 1,838 hospitalizations were matched (Table 1). The odds of complication were 67% higher for hospitalizations in which the patient had IBD (12.7% vs. 8.0%; 95% CI: 25% to 122% higher, p < .001; Table 1). The most common complications included nausea (4.9% vs. 2.5%, p = .002) and gallstones (2.2% vs. 1.1%, p = .069). No statistically significant difference was observed for all-cause 90-day readmissions or LOS; hospital cost was 5% higher for hospitalizations in which the patient had IBD (Table 1).

Conclusions

IBD patients undergoing SG experienced significantly higher post-operative complication rates; however, IBD may not be a significant determinant of hospital readmission. The long-term safety of SG for patients with IBD remains an open question.