• Magnus Strømmen, Inger Johanne Bakken, Christian Klöckner, Jorunn Sandvik, Bård Kulseng, and Are Holen.
• Centre for Obesity Research, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway; Department of Mental Health, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway. Electronic address: magnus.strommen@stolav.no.
• Surg Obes Relat Dis. 2020 Apr 1; 16 (4): 464-470.

BackgroundAfter Roux-en-Y gastric bypass (RYGB) patients are at higher risk of alcohol problems. In recent years, sleeve gastrectomy (SG) has become a common procedure, but the incidence rates (IRs) of alcohol abuse after SG are unexplored.ObjectivesTo compare IRs of diagnoses indicating problems with alcohol or other substances between patients having undergone SG or RYGB with a minimum of 6-month follow-up.SettingAll government funded hospitals in Norway providing bariatric surgery.MethodsA retrospective population-based cohort study based on data from the Norwegian Patient Registry. The outcomes were ICD-10 of Diseases and Related Health Problems diagnoses relating to alcohol (F10) and other substances (F11-F19).ResultsThe registry provided data on 10,208 patients who underwent either RYGB or SG during the years 2008 to 2014 with a total postoperative observation time of 33,352 person-years. This corresponds to 8196 patients with RYGB (27,846 person-yr, average 3.4 yr) and 2012 patients with SG (5506 person-yr; average 2.7 yr). The IR for the diagnoses related to alcohol problems after RYGB was 6.36 (95% confidence interval: 5.45-7.36) per 1000 person-years and 4.54 (2.94-6.70) after SG. When controlling for age and sex, adjusted hazard ratio was .75 (.49-1.14) for SG compared with RYGB. When combining both bariatric procedures, women <26 years were more likely to have alcohol-related diagnoses (3.2%, 2.1-4.4) than women of 26 to 40 years (1.6%, 1.1-2.1) or women >40 (1.3%, .9-1.7). The IR after RYGB for the diagnoses related to problems with substances other than alcohol was 3.48 (95% confidence interval: 2.82-4.25) compared with 3.27 (1.94-5.17) per 1000 person-years after SG. Controlling for age and sex, the hazard ratio was .99 (.60-1.64) for SG compared with RYGB.ConclusionsIn our study, procedure-specific differences were not found in the risks (RYGB versus SG) for postoperative diagnoses related to problems with alcohol and other substances within the available observation time. A longer observation period seems required to explore these findings further.Copyright © 2020 American Society for Bariatric Surgery. Published by Elsevier Inc. All rights reserved.

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