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Obesity Surgery
Published in: Obesity Surgery 4/2010

01-04-2010 | Clinical Report

Fewer Nutrient Deficiencies After Laparoscopic Sleeve Gastrectomy (LSG) than After Laparoscopic Roux-Y-Gastric Bypass (LRYGB)—a Prospective Study

Authors: Simone Gehrer, Beatrice Kern, Thomas Peters, Caroline Christoffel-Courtin, Ralph Peterli

Published in: Obesity Surgery | Issue 4/2010

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Abstract

Background

Deficiencies in micronutrients after bariatric operations are frequent, despite routine supplementation. Main outcome measures were pre- and postoperative frequency of nutrient deficiencies and success rate of their treatment.

Methods

Between 5/2004 and 12/2006, 136 patients (m:f = 0:4) with an average body mass index of 45 (35–58) kg/m2 and age of 53 (21–66) years were prospectively analysed. Laparoscopic Roux-Y-gastric bypass (LRYGB) was performed in 86 patients and laparoscopic sleeve gastrectomy (LSG) was performed in 50 patients. The patients were examined before surgery as well as 3, 6, 12, 24, 30, and 36 months postoperatively using a standard protocol including laboratory tests. The mean follow-up time was 24.4 (12–40) months; the follow-up rate was 100%.

Results

Prior to surgery, 57% of the patients had at least one deficiency, 23% of whom had vitamin D3 deficiency. Frequent postoperative deficiencies after LSG were zinc, vitamin D3, folic acid, iron, and vitamin B12; after LRYGB, vitamin B12, vitamin D3, zinc, and secondary hyperparathyroidism. No vitamin B1 or B6 deficiencies were found. Calcium levels were normal in all patients. Treatment of the deficiencies was mostly successful.

Conclusion

Preoperatively, 57% of morbidly obese patients already had a deficiency. Postoperatively, significantly more vitamin B12 and vitamin D deficiencies and hyperparathyroidism were found in patients who had undergone LRYGB. After LSG, folate deficiency was more frequent (but not significantly so). Calcium levels were normal in all patients; therefore, parathyroid hormone and vitamin D3 levels are more sensitive markers for early detection of disorders of calcium metabolism. Iron deficiency anaemia is most efficiently treated by IV therapy.
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Metadata
Title
Fewer Nutrient Deficiencies After Laparoscopic Sleeve Gastrectomy (LSG) than After Laparoscopic Roux-Y-Gastric Bypass (LRYGB)—a Prospective Study
Authors
Simone Gehrer
Beatrice Kern
Thomas Peters
Caroline Christoffel-Courtin
Ralph Peterli
Publication date
01-04-2010
Publisher
Springer-Verlag
Published in
Obesity Surgery / Issue 4/2010
Print ISSN: 0960-8923
Electronic ISSN: 1708-0428
DOI
https://doi.org/10.1007/s11695-009-0068-4

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