Pancreaticoduodenectomy in Patients with Previous Roux-en-Y Gastric Bypass: a Matched Case-Control Study

Area of Science:

• Gastroenterology
• Surgical Oncology
• Bariatric Surgery

Background:

• Pancreaticoduodenectomy (PD) is a major surgery for pancreatic head pathologies.
• Previous Roux-en-Y gastric bypass (RYGB) may alter patient anatomy and physiology, potentially impacting PD outcomes.
• Limited data exists on PD outcomes in patients with a history of RYGB.

Purpose of the Study:

• To evaluate and compare the outcomes of pancreaticoduodenectomy (PD) in patients with and without a history of Roux-en-Y gastric bypass (RYGB).
• To determine if prior RYGB influences operative time, length of hospitalization, or postoperative morbidity following PD.
• To assess if a history of RYGB delays surgical intervention for pancreatic head pathology.

Main Methods:

• Retrospective case-control study comparing patients who underwent PD after RYGB with matched controls without prior RYGB.
• Data collected from January 2012 to July 2017 across two institutions.
• Matched patients based on age, sex, diagnosis, operative approach, and surgical year (1:3 ratio).

Main Results:

• No significant differences were observed in mean operative time between the RYGB and non-RYGB groups.
• Length of hospitalization and postoperative morbidity rates were comparable between the two groups.
• A history of RYGB did not result in delayed surgical intervention for pancreatic head pathology.

Conclusions:

• Outcomes of pancreaticoduodenectomy are similar for patients with or without a prior Roux-en-Y gastric bypass.
• Prior RYGB does not appear to negatively impact PD outcomes or delay necessary surgical intervention.
• This suggests that RYGB is not a contraindication for PD and that patients can expect similar results.