Efficacy of Metabolic and Bariatric Surgery for the Treatment of Recurrent Hypertriglyceridemia-Induced Acute Pancreatitis.

Abstract

Background: Obesity is a predisposing factor for the onset of hypertriglyceridemia-induced acute pancreatitis (HTG-AP). Metabolic and bariatric surgery (MBS) has demonstrated significant short-term efficacy in the treatment of HTG-AP. The current evaluated the long-term efficacy of MBS for the management of recurrent HTG-AP.

Methods: Between 01 January 2015 and 31 August 2019, a total of 51 patients diagnosed with obesity combined with HTG-AP at our hospital were enrolled in the study. 14 underwent laparoscopic sleeve gastrectomy (LSG), 9 underwent laparoscopic Roux-en-Y gastric bypass (LRYGB), and 28 underwent routine treatment including dietary therapy, pharmacotherapy, and plasma exchange. The aim of the study was to investigate the long-term therapeutic effects of LRYGB, LSG, and routine treatment on recurrent HTG-AP, and to assess patient prognoses under different treatment modalities.

Results: The LSG and LRYGB groups achieved significant average weight loss, whereas the changes in the routine treatment group were not significant. The LRYGB group exhibited more weight loss than the LSG group. In both the LSG and LRYGB groups triglyceride levels decreased significantly within the first year after surgery. The routine treatment group exhibited a pancreatitis recurrence rate of 57.14%, compared to 15.38% in the LSG group and 11.11% in the LRYGB group.

Conclusions: Over a period of 5 years, LSG and LRYGB exhibited superior efficacy with respect to managing metabolic syndrome associated with recurrent HTG-AP, particularly by enhancing weight management and reducing the pancreatitis recurrence rate. These findings support the long-term efficacy of MBS for the treatment of recurrent HTG-AP.