The effects of gastric surgery on serum ferritin concentrations

Changes in serum ferritin concentrations were monitored for three months after gastric operation, in 25 patients. In 23 patients, the serum ferritin concentration was seen to be increased, one week postoperatively, as compared with the preoperative level. Thereafter, in most patients, the serum ferritin concentration gradually decreased to the initial preoperative level. Preoperatively, 13 of the total 25 patients had low serum ferritin concentrations, indicating depleted iron stores. In eleven of these patients, the serum ferritin concentrations followed the above-mentioned course and normal values of serum ferritin concentration were seen postoperatively, indicating normal body iron stores. In six of the ten patients with normal preoperative serum ferritin concentrations, there was a temporary increase within the limits of the normal range. The temporary postoperative increase of serum ferritin concentration was more marked in the patients who underwent total or partial gastrectomy than highly selective vagotomy or fundoplication. We conclude that measurement of serum ferritin concentration may give a false impression of normal body iron stores in the postoperative state.