Long-term home parenteral nutrition in chronic intestinal failure following metabolic and bariatric surgery and its clinical outcomes: A descriptive cohort study.

Abstract

Background: Metabolic and bariatric surgery is one of the most efficacious treatments for obesity. The increasing incidence of referrals to intestinal rehabilitation programs and the necessity for long-term parenteral nutrition because of bariatric surgery complications have gained attention, yet data remain limited. Our objectives were to (1) assess parenteral nutrition-related complication rates of patients requiring long-term parenteral nutrition because of bariatric surgery complications and (2) compare outcomes between types of metabolic and bariatric surgery.

Methods: This was a descriptive cohort (n = 25) study, which gathered data from patients enrolled in the national registry with a history of metabolic and bariatric surgery at baseline and 2 years and included demographics, biochemical parameters, parenteral regimens, line sepsis, hospitalizations, and functional status.

Results: In this study, 92% were women with a mean age of 53.8 ± 8.6 years. The most prevalent procedure performed was Roux-en-Y gastric bypass (60%). Short bowel syndrome was observed in 40% of our cohort (n = 10). After 2 years, there was a significant reduction in the need for parenteral nutrition compared with baseline, with 37.5% of patients achieving weaning. No significant disparities were observed in the incidence of line sepsis, hospitalizations, or Karnofsky performance status between baseline and the 2-year follow-up, regardless of the type of surgery. Roux-en-Y gastric bypass was associated with lower body mass index at the 2-year mark.

Conclusion: In post-metabolic and bariatric surgery patients, long-term parenteral nutrition is well tolerated based on clinical outcomes and functional status is not influenced by the type of surgery.