Bariatric surgery in duodenal switch procedure: weight changes and associated nutritional deficiencies

Abstract

IntroductionBariatric surgery using the duodenal switch procedure is considered to be one of the most effective treatments for achieving weight loss and decreasing comorbidity in patients with morbid obesity. However, this procedure may be associated with various nutritional deficiencies that should be known and adequately managed. ObjectivesTo assess weight loss and the occurrence of nutritional deficiencies in morbidly obese patients undergoing bariatric surgery using a duodenal switch procedure. Patients and methodsOne hundred and twenty-eight morbidly obese patients underwent a duodenal switch procedure at Hospital General Universitario in Albacete. Weight changes and the most important nutritional deficiencies occurring after surgery were recorded. ResultsMedian follow-up time was 30 months (interquartile range, 18 months). Body weight markedly decreased, with mean body mass index (BMI) decreasing from a preoperative value of 52.9±7.7kg/m2 to 30.8±5.2kg/m2 18 months after surgery. Percent excess weight loss (%EWL) was 81.4±16.4% in this period. Weight loss slowed down subsequently, reaching its lowest value 30 months after surgery (%EWL 82.1%±16.8, BMI 30.2±4.3kg/m2) and tended to stabilize in patients with longer follow-up times. The most significant nutritional deficiencies requiring replacement therapy were found in some micronutrients such as iron (42.9%), zinc (38.3%), vitamin A (55.5%), and vitamin D (57.8%), amongst others. ConclusionsDuodenal switch is a very effective surgical procedure for treating morbidly obese patients because it allows them to achieve a significant and sustained weight loss. Close lifetime monitoring is required in these patients because of the high prevalence of nutritional deficiencies during follow-up.