Antibiotic use as a predictor of laparoscopic sleeve gastrectomy success
Ben-Avie, Yedidya   (Massachusetts General Hospital)
Mentor: Tavakkoli, Ali (Brigham and Womens Hospital)
Although sleeve gastrectomy is one of the most common forms of bariatric surgery used for the treatment of type 2 diabetes and obesity, not enough is known about why some patients fail to respond to the surgery by achieving weight loss and diabetes remission. Recent research has pointed to the negative effects of antibiotic use on weight and blood sugar control, suggesting a possible link between antibiotic use, infection, and sleeve gastrectomy outcomes. To test the hypothesis that antibiotic use before or after sleeve gastrectomy surgery would lead to worse response to the surgery, we analyzed 144 patients with type 2 diabetes who underwent sleeve gastrectomy and compared their outcomes at one year post-op. Patients were grouped by whether they used antibiotics before surgery, after, both before and after, or neither before nor after. We also looked to see whether the type of antibiotic used for perioperative prophylaxis would have an effect on one year outcomes. There were no significant differences between any of these groups. For pre-op use (n = 10), post-op use (n = 39), both (n = 11), and neither (n = 83) the results were as follows: BMI change, 8.33 + 3.69 kg/m2, -8.73 + 5.68 kg/m2, - 9.92 + 3.21 kg/m2, -9.72 + 5.42 kg/m2; for Hba1c change, -1.08 + 0.70%, -0.37 + 1.51%, -0.10 + 1.18%, -0.77 + 1.53%; and for the percent of each group reliant on medications for blood sugar control, 13%, 49%, 30%, and 47%. The analysis of perioperative antibiotic use type also had no significant between group differences. Overall, this shows that antibiotic use did not have an effect on the one year outcomes of sleeve gastrectomy. From these results, we can conclude that even patients who get sick during the first year after sleeve gastrectomy surgery still benefit from the surgery. Additionally, recent infection should not be a reason to delay surgery since patients with preoperative antibiotic use had positive outcomes.