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[Nutritional status after surgical treatment of obesity]
Serena Tonstad1, Tine Sundfør, Eli Anne Myrvoll
1Avdeling for preventiv kardiologi, Ullevål universitetssykehus, 0407 Oslo. serena.tonstad@uus.no
Background:
Biliopancreatic bypass with duodenal switch is a treatment for morbid obesity that combines restriction of dietary intake with a high degree of malabsorption. The operation involves the risk of losing important nutritional elements.
Material And Methods:
64 women and 14 men who had a biliopancreatic bypass with duodenal switch performed in 2002 - 2005 and were followed up at least once, six months or later after surgery, were examined with 3 to 6-month intervals for the following; body weight, clinical status, haematological variables, ferritin, folate, albumin, creatinine, retinol, alpha-tocopherol/lipids, vitamin D metabolites, parathyroid hormone, vitamin B1, lipids, glucose and other clinical chemical variables.
Results:
Weight loss after surgery was substantial and rapid, from a mean of 153.8 kg (SD 30.2) to 92.7 kg (SD 21.6) after one year (n = 74). Low values of serum albumin, creatinine, retinol, 25-OH vitamin D and elevated parathyroid hormone were very common. Four women and three men (9 % of all) with common channels of < 100 cm, required a surgical revision mainly due to hypoalbuminemia. Two women became pregnant before the recommended 18 months after surgery.
Interpretation:
Biliopancreatic bypass with duodenal switch in patients with common channels < 100 cm, has a high rate of complications and nutritional deficiencies. This surgery should be used restrictively.
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