Bariatric Surgery Linked to Acute Pancreatitis Risk

  • Written by: Martha Garcia

New research suggests that bariatric surgery, commonly done to help people lose weight and improve other health factors, may increase the risk of acute pancreatitis. 

In a study published in the December issue of Obesity Surgery, researchers from the Cleveland Clinic in Ohio found many patients who underwent different types of bariatric surgery also developed acute pancreatitis.

Researchers followed nearly 2,700 patients who underwent some type of bariatric surgery between January 2004 to September 2011. Patients underwent either Roux-en Y gastric bypass, sleeve gastrectomy, adjustable gastric banding or other procedures.

Out of 2,695 subjects who underwent bariatric surgery, 28 (1.04%) developed acute pancreatitis during a follow-up of three and a half years. One of those patients died of complications associated with acute pancreatitis as a result.

While obesity is seen as a potential factor in the development of acute pancreatitis, the rate seen among bariatric surgery patients was significantly higher than the rate of acute pancreatitis in the general population, researchers noted.

Out of the 28 patients that suffered acute pancreatitis, almost half were determined to have other abnormal findings as well, including a prior history of pancreatitis, gallstones or ductal dilation. Researchers said these abnormalities, and others, could be predictors of whether a bariatric surgery patient was at an increased risk of acute pancreatitis.

Rapid weight loss was one of the key predictors of acute pancreatitis; a significant factor patients are hoping to achieve after undergoing bariatric surgery.

The average body mass index (BMI) before surgery was 47.4, which dropped to 38.3 within an average of one and a half years post-op.

Researchers found that 79% of those who suffered acute pancreatitis underwent gastric banding, also known as the Lap-Band. However, the researchers noted that type of surgery was far more popular than other bariatric surgeries, which could account for why so many cases were associated with it.

A study published late last year revealed gastric bypass surgery offers patients more weight loss, but is also more likely to cause complications. In fact, patients who underwent gastric banding lost twice the amount of weight as other bariatric surgeries, but experienced higher risks of short term complications and long-term hospitalizations.

Another consideration researchers discussed was the factor of chronic low-grade inflammation caused by obesity. This can put patients at risk for developing more severe acute pancreatitis. Often inflammatory markers do not decrease after surgery for six to 24 months.

Alcohol induced pancreatitis was not seen during the study, but researchers admitted alcohol use may be an under-recognized cause of acute pancreatitis. One patient who denied alcohol use and developed acute pancreatitis was later treated for alcohol dependence one year later.

Increasing Obesity Leading to More Surgeries

The prevalence of obesity in the U.S. reached nearly 36% in 2010 with the frequency of bariatric surgeries becoming increasingly common. Researchers estimate 53 procedures were conducted per 100,000 adults in 2008.

The American Medical Association officially named obesity as a recognizable disease in 2013.

More than 150,000 people will elect to undergo some form of bariatric surgery each year. With advancements in surgery, the mortality rate dropped to 0.1%. However, a study published in 2011 highlighted a large number of serious complications following bariatric surgery. Researchers found side effects of weight loss surgery can include malnutrition, vision problems, vitamin deficiencies and other serious complications.

More procedures can mean more complications. A study published in October of last year concluded bariatric surgery can lead to reduced long-term survival rates, risks of microvascular and macrovascular events and negative mental health outcomes.

“Because of the growing recognition of obesity as a disease and the increasing number of bariatric surgeries, it is vital to understand potential complications in this patient population,” the researchers determined.

Researchers say it is important to have careful follow-up with radiological monitoring if bariatric surgery patients show warning factors for acute pancreatitis.

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  1. Sherry Reply

    I have had pancreatitis 26 times since having my sleeve surgery in Jan 2013. Now I have chronic pancreatitis and pain on a daily basis, take synthetic enzymes and other meds just to be able to eat. I wish I had never had it done.

  2. Charity Reply

    I had gastric bypass in 2003. Almost 2 years later I had acute pancreatitis and continued to get it. After 2 years they reversed the surgery in order to actually get to my pancreas, which had turned chronic. Also had another surgery 2 years later to remove part of my pancreas which was unsuccessful. Now 11 years later I’ve been more in the hospital than out, almost dieing numerous times and have several other health issues from having the pancreatitis. I feel like it is slowly killing me!

  3. Elissa Reply

    I have had pancreaitis 7 times in the first 3 yrs since my gastric bypass surg. I hv developed chronic ulcers (1perforated in Oct 2016). Despite being a nom-smoker, stopped all use of NSAIDS & being on the maxium medicine regime, I still hv it.
    Pancreatitis was never explained 2 Nye as a possible complication – there is a very strong family history.
    Now where I had to surg done, no longer accepts no 82nd. Living in a small time, the dr’s & local hospitals hv not been able 2 treat me. Now I waiting for a GI consult at a major unniversity center out-of-town.
    Dr’s needs to be educated more the pancreatitis & the connection of the gastric bypass. The is a real -PAINFUL- complication, that more education & treatment needs 2 be done. Listen to YOUR patients. Once Y hv pancreatitis – it is a pain like no other – u know when ur going into an attack before I even get the bld work results back.

  4. Viki Reply

    I had horrific diarrhea for 10 months and some days could not leave the house. I went to 2 gastro men. One was a down right quack and the other was amazing! He found that my pancreas is not working due to my gastric bypass. I am now on medicine that costs 2800.00 a month!!! I have no idea where this is all heading but I can guarantee it is not good. I still have bouts of this going on even with the meds.
    I was NOT told of this problem. I had a gastric band first and it grew scar tissue around it so my bypass surgeon suggested the bypass. Its been an interesting ride and its a race I am sure I will not win.

  5. Jolie Reply

    My husband had laproscopic gastric bypass surgery in 2015. He developed acute necrotizing pancreatitis in 2017. He passed away in July of 2019. Could his death have been caused by a complication from the bypass surgery?

  6. Bonnie Reply

    I had lap band done seven years ago. I have chronic esophagitis and just started having pain pain pain. The research I’ve done leads me to believe it’s pancreatitis! What is the prognosis?

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