S3157 Impact of Preoperative Cannabis Use on Outcomes Following Surgical Intervention for Gastroparesis

Introduction: Cannabis use delays gastric emptying and may exacerbate symptoms of gastroparesis. However, its impact on outcomes after surgical intervention remains poorly defined. We aimed to compare postoperative outcomes between patients with and without preoperative cannabis use. Methods: A retrospective cohort study was conducted using TriNetX, a federated electronic medical record database. Adults (18-89 years) with gastroparesis who underwent pyloric drainage surgery or gastric stimulator placement were stratified by the presence or absence of a cannabis-related diagnosis (ICD-10 code F12) prior to surgery. Outcomes were assessed over the first 90 days and up to 5 years postoperatively. Statistical comparisons included risk analysis, Kaplan-Meier survival, and number of instances. Results: Of 1,595 patients who underwent an intervention for gastroparesis, 108 (7.25%) had documented preoperative cannabis use. Cannabis users had higher rates of diabetes, gastroesophageal reflux disease, and preoperative nausea/vomiting and abdominal pain symptoms, but similar rates of bloating. Within 90 days of surgery, cannabis users experienced higher rates of reintervention (9.3% vs 1.2%; P < 0.001) and inpatient admissions (32.4% vs 23.7%;P = 0.042), but fewer clinic visits (37.0% vs 54.5%; P < 0.001). At a mean (standard deviation) follow-up of 1,049 (615) days, reintervention rates were similar (12.0% vs 11.3%; P = 0.808). However, cannabis users had higher hospital admission rates (59.2% vs 41.0%; P < 0.001), yet persistently lower outpatient utilization (54.6% vs 76.2%; P < 0.001) with a fewer number of visits (8.0 [18] vs 12.2 [2]); P = 0.045). Need for gastrectomy rates were similar (0.0% vs 0.7%; P = 0.989). Conclusion: Preoperative cannabis use is associated with a greater symptom burden, increased early reintervention, reduced outpatient engagement, and greater long-term healthcare utilization after surgical intervention for gastroparesis. These patients may represent a more symptomatic population and may benefit from closer follow-up to reduce readmissions.