Commentary Regarding Flancbaum L, Belsley S, Drake V, Colarusso T, Tayler E. Preoperative Nutritional Status of Patients Undergoing Roux-en-Y Gastric Bypass for Morbid Obesity. J Gastrointest Surg. 2006 10(7):1033–7

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Nutritional deficiencies are a known complication following Bariatric procedures, especially after malabsorptive procedures, such as Roux-en-Y gastric bypass and biliopancreatic diversion, but may occur after restrictive procedures, as after any gastrointestinal surgery.1‐ 6 Various nutritional deficiencies were described after these procedures.1‐ 6 The gravest presentations were described in accordance with thiamine deficiency leading to severe neurological pathology.1,2,6 A study by Flancbaum and coworkers7, which was published in 2006, retrospectively analyzed the preoperative values of various nutrients, including thiamine, in patients undergoing bariatric surgery. Twenty-nine percent of the patients had preoperative thiamine deficiency. In their study, the authors stated that they were the first to describe preoperative thiamine deficiency in bariatric patients. However, Flancbaum’s study only confirmed what we have presented at the 22nd Annual Meeting of the American Society for Bariatric Surgery on June 2005, and published in 20058, in which we demonstrated that, out of 303 morbidly obese patients who were scheduled for bariatric surgery, 47 patients (15.5%) presented with low preoperative thiamine levels. In our study, none of the patients had preoperative or postoperative clinical manifestations of thiamine deficiency. …