The Effects of Metabolic Bariatric Surgery on Intra-pancreatic Fat Deposition and Total Pancreas Volume: a Systematic Review and Meta-analysis.

Abstract

Bariatric procedures are common interventions for weight loss and metabolic improvements; yet, their effects on the pancreas-a key metabolic organ-are largely unknown. This systematic review aimed to summarise data on changes in intra-pancreatic fat deposition (IPFD) and total pancreas volume (TPV) following metabolic bariatric surgery and endoscopic bariatric therapy. The literature search was conducted in MEDLINE and Embase databases. Studies in humans were included if they reported on changes in IPFD and/or TPV from before to after bariatric procedure. Random effects meta-analysis was conducted. Fourteen studies (all involving metabolic bariatric surgery) met the eligibility criteria. Metabolic bariatric surgery resulted in a mean absolute IPFD reduction of 3.9% (p = 0.003) and a mean TPV decrease of 10.7 cm³ (p < 0.001). The mean relative IPFD reduction after metabolic bariatric surgery was 35.9%. Sleeve gastrectomy led to a higher mean relative IPFD reduction than Roux-en-Y gastric bypass (39.9% vs. 20.6%), though this difference was not statistically significant. Analysis of follow-up duration showed a mean relative IPFD reduction of 8.8% in patients with follow-ups of less than 3 months. Metabolic bariatric surgery leads to significant reductions in IPFD and TPV. Follow-up should take place no earlier than 3 months for the full benefits of bariatric procedures on the pancreas to manifest.