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

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.