Evidence map›Paper›PMID 35768735›Full record

ArticleSurgical endoscopy2023

Exocrine pancreatic insufficiency after bariatric surgery: a bariatric surgery center of excellence experience.

Hope N Moore, Alexis R Chirco, Trevor Plescia, Shushmita Ahmed, Barbara Jachniewicz, Ganesh Rajasekar, Mohamed R Ali, Victoria Lyo

Abstract read
PubMed Publisher
In one paragraph

Article in Surgical endoscopy, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
13citing papers in PubMed, 3 pooled it
2.8field-weighted citation impact, top 9% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

13 citing papers in PubMed, 3 syntheses or guidelines pooled it, 16 citations in OpenAlex.

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  6. Unique causes of exocrine pancreatic insufficiency: When to consider pancreatic enzyme supplementation: A narrative review.Nutrition in clinical practice : official publication of the American Society for Parenteral and Enteral Nutrition · 2026
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors at 2 institutions in 1 country.

Hope N MooreDepartment of Surgery, University of California Davis Health, Sacramento, CA, USA.
Alexis R ChircoUniversity of California, Davis, CA, USA.
Trevor PlesciaDepartment of Surgery, University of California Davis Health, Sacramento, CA, USA.
Shushmita AhmedDepartment of Surgery, University of California Davis Health, Sacramento, CA, USA.
Barbara JachniewiczDepartment of Surgery, University of California Davis Health, Sacramento, CA, USA.
Ganesh RajasekarDepartment of Surgery, University of California Davis Health, Sacramento, CA, USA.
Mohamed R AliDepartment of Surgery, University of California Davis Health, Sacramento, CA, USA.
Victoria LyoDepartment of Surgery, University of California Davis Health, Sacramento, CA, USA. vlyo@ucdavis.edu.ORCID http://orcid.org/0000-0003-3139-7365
University of California, Davis · USUniversity of California System · US

Funding

UC Davis Clinical and Translational Science CenterUL1TR001860 · NCATS · UNIVERSITY OF CALIFORNIA AT DAVIS · PI KENYON, NICHOLAS J., LYLES, COURTNEY REES · 2016 to 2025
$47.3M
NCATS NIH HHS UL1 TR001860
6 · The paper itself

Abstract

introductionGastrointestinal symptoms such as diarrhea, bloating, abdominal pain, and nausea are common after bariatric surgery (BS) and can lead to significant morbidity. While many diagnoses can explain these symptoms, post-bariatric exocrine pancreatic insufficiency (EPI) is becoming increasingly recognized as contributor to gastrointestinal symptoms. The frequency and outcomes of EPI after BS are not well understood. We investigated the prevalence and outcomes of EPI over 18 years at a tertiary bariatric referral center.

methodsA retrospective review of patients who underwent primary or revisional BS from 2002 to 2020 was performed. Patients were included if they were suspected of having EPI or underwent fecal elastase testing (FE-1). EPI diagnosis was defined as positive FE-1 testing or improvement with empiric pancreatic enzyme replacement therapy (PERT).

resultsEPI was suspected in 261 patients, and 190 were tested via FE-1 (89.5%) or empirically treated (10.5%). EPI was diagnosed in 79 (41.6%) patients and was associated with older age and lower BMI. Therapeutic PERT was given to 65 patients diagnosed with EPI, and 56 (86.2%) patients reported improved symptoms. Patients who underwent RYGB and BPD-DS were more likely to have EPI than those after SG (47.9% and 70.0% vs 17.4%, p < 0.01). EPI diagnosis was associated with a history chronic pancreatitis. While diarrhea and abdominal pain were the most common symptoms prompting FE-1 testing, no symptoms were significantly associated with EPI. EPI was also associated with abnormal fecal fat results and treatment with bile acid sequestrants, but not small intestinal bacterial overgrowth.

conclusionThis study highlights that exocrine pancreatic insufficiency can account to for previously unexplained GI complaints after bariatric surgery. Therefore, bariatric surgery programs should consider this diagnosis in symptomatic patients, especially following RYGB and BPD-DS. Further work to define patient factors that should prompt evaluation, optimal treatment, and prevention is necessary.

Indexed as

Bariatric SurgeryExocrine Pancreatic InsufficiencyGastrointestinal DiseasesAbdominal PainDiarrheaHumansPancreasBariatric surgeryExocrine pancreatic insufficiencyPancreatic enzyme replacement therapyRoux-en-Y gastric bypassSmall intestinal bacterial overgrowth

Identifiers

PMID35768735
OpenAlexW4283761526

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.