2064 Favorable Outcomes Among IBD Patients Undergoing Bariatric Surgery: A Case Series

Abstract

INTRODUCTION: The prevalence of obesity continues to rise worldwide. It has been demonstrated that conditions such as T2DM and gallbladder disease, among other comorbidities, are related to Class II and III obesity (BMI ≥ 35). To combat this issue, bariatric surgery has been shown to be the most effective and durable weight loss method in individuals with a BMI ≥ 40 or BMI ≥ 35 with an obesity-related comorbidity. The rate of obesity among IBD patients parallels that of the general population and is approaching 30% nationwide. In recent years, there has been an increase in clinical research supporting the use of bariatric surgery within the IBD population as a safe and efficacious treatment option. CASE DESCRIPTION/METHODS: We present a case series of patients with a pre-operative diagnosis of IBD who underwent bariatric surgery at our hospital. Selection process was based on an ICD 9 or 10 diagnosis of IBD prior to Bariatric Surgery referral. Patients with a diagnosis of IBD but not followed by a gastroenterologist were excluded from this review. Patient data was extracted by the Clinical Research Data Service team from the electronic medical record. They identified 144 patients with IBD diagnoses who were seen at bariatric surgery clinic from 2003-2018. 5 IBD patients (3 CD, 2 UC) who underwent bariatric surgery were included in this data set and analyzed for IBD disease activity, operative complications, mortality, post-operative complications and overall excess weight loss (%EWL) at 6-month follow-up. All IBD patients who had bariatric surgery at this facility were included in data analyses. Bariatric surgical procedures included sleeve gastrectomy and Roux-en-Y. Mean age at time of referral was 43 years ± 12. One major perioperative complication was identified in a UC patient, pulmonary embolism complicated by splenic infarct. %EWL at 6-month follow-up was 35.4% ± 12.8. No patients required rehospitalization and mean length of hospital stay for the operation was 2.5 days ± 1.7. DISCUSSION: There were no IBD-related complications (glucocorticoid use or rehospitalization) seen within 30 days of surgery and no major complications (including SBO) were noted within a median follow-up of 54 months. As clinical data continues to emerge regarding bariatric surgery in the obese IBD population, it has become increasingly apparent that the pre-operative diagnosis of IBD should not exclude considerations for utilizing a surgical treatment modality for weight reduction in select patients.