Cannabis Use Did Not Worsen Major Complications After Liver and Pancreas Surgery

Cannabis users (0.89% of 191,315 patients) had no significant differences in in-hospital mortality, acute kidney injury, blood transfusion, mechanical ventilation, venous thromboembolism, surgical site infection, or other major complications compared to non-users. Cannabis users had significantly lower odds of pneumonia (OR 0.54, 95% CI 0.29-0.99). No differences in length of stay or hospitalization costs.

Retrospective analysis of the Nationwide Inpatient Sample (2016-2020). 191,315 HPB surgery patients identified, 1,705 (0.89%) with cannabis use. Multivariate analysis adjusted for demographics and comorbidities compared complications, length of stay, and costs.

Surgeons and anesthesiologists need to know whether cannabis use affects surgical outcomes. This national database analysis provides reassurance that cannabis use does not appear to worsen major perioperative complications after complex abdominal surgery.

While reassuring for surgical planning, the lower pneumonia rate in cannabis users is unexpected and warrants cautious interpretation. It may reflect healthy user bias or demographic differences rather than a protective effect of cannabis.

Administrative database with ICD coding limitations. Cannabis use likely underreported. Cannot determine dose, frequency, or recency of use. Healthy user bias possible. Cannot distinguish between active and former users. Observational design.