Türkçapar Bariatrics, Obesity Center, İstanbul, Turkey.
İstanbul Bariatrics, Obesity and Advanced Laparoscopy Center, İstanbul, Turkey.
J Laparoendosc Adv Surg Tech A. 2021 Jan;31(1):24-28. doi: 10.1089/lap.2020.0306. Epub 2020 Jun 11.
Several studies demonstrated increased alcohol intake after gastric bypass but not for laparoscopic sleeve gastrectomy (LSG). The purpose of this study is to determine whether there is an increased risk of developing alcohol use disorder after LSG. LSG patients with at least 1-year follow-up who completed the alcohol use disorder identification test (AUDIT) preoperatively, and at their control visit, were the subjects. AUDIT was applied to the patients who were followed up from 1 to 6 years postoperatively. Patients were divided into two groups as those who were followed for 1-3 years and 4-6 years. AUDIT scores and risk categories were compared. According to the AUDIT results, score intervals between 0-7, 8-15, 16-19 and 20-40 identified patients with low, moderate, high risk, and alcoholism, respectively. There were 183 LSG patients eligible for inclusion. An AUDIT score of 2.79 before LSG showed prominent reduction in alcohol use in the first 3 years after LSG with a score of 2.27 ( = .033). At 4-6 years follow-up, AUDIT scores showed significant increase from 3.06 to 4.04, suggesting an increase in alcohol use in the long term ( = .042). In addition, the increase of risk after surgery in pre-LSG moderate-risk category ( = 21) turned out to be higher than pre-LSG low-risk category ( = 162). This study showed reduction in AUDIT scores in the first 3-year follow-up after LSG and increase in the 4-6 years follow-up. High pre-LSG AUDIT score, a potential risk for future alcohol use disorder, was one of the key findings of our study. Screening of LSG candidates before and after surgery by AUDIT scoring according to risk categories with larger samples will provide useful input for relevant guidelines.
几项研究表明,胃旁路手术后饮酒量增加,但腹腔镜袖状胃切除术(LSG)并非如此。本研究旨在确定 LSG 后是否存在发生酒精使用障碍的风险增加。
至少随访 1 年且术前完成酒精使用障碍识别测试(AUDIT),并在控制访视时完成该测试的 LSG 患者。对术后随访 1-6 年的患者应用 AUDIT。患者被分为随访 1-3 年和 4-6 年两组。比较 AUDIT 评分和风险类别。根据 AUDIT 结果,0-7、8-15、16-19 和 20-40 分区间分别表示低、中、高风险和酒精中毒。
共有 183 例 LSG 患者符合入选标准。LSG 前 AUDIT 评分为 2.79,提示 LSG 后 3 年内饮酒量明显减少,评分为 2.27( = .033)。4-6 年随访时,AUDIT 评分从 3.06 升高至 4.04,提示长期饮酒量增加( = .042)。此外,术前中危组( = 21)的手术风险增加,高于术前低危组( = 162)。
本研究显示,LSG 后 3 年的随访中 AUDIT 评分降低,4-6 年的随访中评分升高。术前高 AUDIT 评分(提示未来发生酒精使用障碍的潜在风险)是本研究的主要发现之一。通过 AUDIT 评分对术前和术后的 LSG 候选者进行风险类别筛查,并进行更大样本量的筛查,将为相关指南提供有用的依据。