Background

Hypertriglyceridemia is associated with obesity and can result in pancreatitis. Obesity is a known cause of secondary hypertriglyceridemia, however, little is known on the effect of metabolic surgery on triglyceride levels and associated outcomes.ObjectiveThis study aims to determine the effect of bariatric surgery on patients with severe hypertriglyceridemia.

Methods

This is a retrospective cohort study including patients with severe hypertriglyceridemia (TG >= 885 mg/dl) who underwent metabolic surgery and had severe hypertriglyceridemia at a single academic institution. Patient baseline characteristics were collected as well as preoperative and postoperative triglyceride levels, pancreatitis episodes, and diabetes-related outcomes.

Results

A total of 88 patients were identified with severe hypertriglyceridemia. The study population included 48 females (54.6%) and 74 (84.1%) were Caucasian. Laparoscopic procedures included Roux-en-Y gastric bypass (n=59, 67%) and sleeve gastrectomy (n=26, 29.5%). The average age was 47.8 years (SD +- 11.15), preoperative BMI was 42.86 kg/m2 (SD +- 7.05), triglyceride level was 1456.61 mg/dl (SD +- 777.5), and 13 (14.8%) patients had at least one prior pancreatitis episode. Postoperatively, triglyceride levels dropped to an average of 185.36 mg/dl (SD +- 138.92) over a follow-up of 6.1 years (SD +- 4.2). Dyslipidemia was either improved or resolved in 71 (80.7%) patients, only 7 (8%) patients had postoperative pancreatitis, and 2 patients had to be readmitted for pancreatitis.

Conclusions

Metabolic surgery can significantly improve dyslipidemia and improve clinical outcomes such as readmissions and pancreatitis for this unique patient population.