Violeta Popov

Tu1478 Risk Factors Associated With Post-Operative Complications After Gastric Bypass: A Nationwide Analysis

be hyperplasic after RYGB surgery in murine models, can improve glucose homeostasis by increasing its own glucose requirements. Aim: To evaluate in rats and humans how the remodeling of the gut epithelium after RYGB impacts on absorption and consumption of sugar by the alimentary Roux limb. Methods: High-fat diet-induced obese male Wistar rats were randomly assigned to RYGB or sham surgery. Two weeks later, jejunum, alimentary Roux and bypassed limbs were collected to perform histological analyses and evaluate relative mRNA levels (qPCR) and protein expression (immunostaining) of sugar transporters (GLUTs and SGLT-1). Glucose transport and consumption were assayed using ex vivo jejunal loops everted (serosal to luminal) or not (luminal to serosal), with [14C]-glucose as substrate, mimicking blood and dietary sugar transport, respectively. Non parametric Mann-Whitney tests were used to compare sham and RYGB. Histological analyses and immunostaining of Ki-67 and GLUT1 were performed on formalin-fixed Roux limb sections obtained from RYGB patients that underwent reoperation for late complications. Perioperative samples of obese patients were used as control. Roux limb glucose consumption was assayed post operatively by PET/CT scan imaging. For all procedures, patients written consent was obtained. Results: RYGB surgery in obese rats recapitulates the beneficial effects seen in humans including improvement of glucose homeostasis. Histological analyses of the alimentary Roux limb revealed a hyperplasic mucosa with a dramatic increased number of Ki67proliferating cells in the crypts [a]. 60 min after luminal or serosal loads of [14C]-glucose in rat jejunal loops, higher amounts of [14C]-glucose were found in the Roux limb [b] (+150% or +400% vs. sham, P<0.001) suggesting an increased glucose consumption. Similarly, increased [18F]-FDG uptake by the Roux limb was observed in RYGB patients by PET/ CT scanning. In rats, the relative mRNA expression pattern of intestinal sugar transporters was dominated by Glut1 [c] (x3 P<0.05 vs. sham). This was confirmed by a strong immunolabeling of GLUT1 protein at the villis top both in RYGB rats and humans. Conclusions: RYGB surgery induces an overgrowth of the alimentary limb in humans. This adaptive mechanism requires energy and induces reprogramming of sugar metabolism exemplified by GLUT1 expression. By increasing dietary and blood glucose consumption, the rearranged gut could improve glucose disposal during and betweenmeals and contribute to diabetes resolution.

Mo1061 Analysis of Factors Predictive of Postoperative Complications in Whipple Procedure

Introduction:Health disparities are a global public health concern. The literature documenting racial and ethnic disparities in healthcare resource utilization is extensive. Fewer studies to date have addressed the differential impact among obese and non-obese populations, especially in the inpatient setting. To our knowledge, this is the first study investigating whether obese patients are less likely to undergo endoscopic evaluation and imaging studies for common inpatient gastroenterology diagnoses. Aims: To evaluate whether patients with a Body Mass Index (BMI) of ≥ 30 undergo fewer inpatient endoscopies and colonoscopies for established clinical indications. Secondary aims include abdominal imaging, length of stay (LOS), and total hospitalization charge. Methods: This was a retrospective cohort study using the 2012 Nationwide Inpatient Sample (NIS), a nationally representative database of inpatient admissions. Adult patients were included if they had an ICD-9 CM code indicating a principal gastroenterology diagnosis as shown in Table 1. The primary outcome was inhospital resource utilization, specifically endoscopies and colonoscopies. Additional outcomes included abdominal CT scans and MRIs, LOS and total hospitalization charge. The exposure of interest was obesity, defined as a BMI≥30. Crude and adjusted odds ratios were calculated using univariable and multivariable regression analyses. Results: A total of 1,416,154 patients met inclusion criteria. The number of obese versus non-obese patients presenting with each diagnosis is summarized in Table 1. Adjusted odds ratios for primary and additional outcomes are shown in Table 2. Compared to non-obese patients, obese patients underwent fewer endoscopies (OR=0.84 CI: 0.80 to 0.88, p<0.001) and colonoscopies (OR=0.76 CI: 0.72 to 0.80, p<0.001). Mean LOS did not differ between obese and non-obese individuals (5.00 vs. 4.54, p-value 0.074).Mean total charge of hospitalization was significantly more for obese patients (

Effect of Intragastric Balloons on Liver Enzymes: A Systematic Review and Meta-Analysis

38,244 vs.

Adverse Events with use of Ustekinumab: A Systematic Review and Meta-Analysis

30,585, p-value 0.001), with an additional

379 The Impact of Intragastric Balloons on Obesity-Related Co-Morbidities: A Systematic Review and Meta-Analysis

6,190 spent if patient was obese (p-value <0.001). Conclusions: Obese patients undergo fewer endoscopies and colonoscopies to evaluate common inpatient gastroenterology diagnoses, however, MRIs are more highly utilized. While the LOS does not differ between these groups, this healthcare disparity may contribute to the increased hospital charges identified for obese patients in this study, and the overall increase in healthcare utilization. Table 1: Principle gastrointestinal conditions included in analyses and incidence of diagnosis between obese and non-obese patients