Cirugía bariátrica mediante la técnica del cruce duodenal: evolución ponderal y deficiencias nutricionales asociadas

Abstract

Introduction Bariatric surgery using the technique of duodenal switch is considered as one of the most effective treatments to lose weight and decrease comorbidity in morbidly obese patients. However, we have to be familiar with and adequately manage the various nutritional deficiencies that may occur as a consequence of its practice. Objectives To assess weight loss and development of nutritional deficiencies in morbidly obese patients undergoing bariatric surgery through the duodenal switch procedure. Material and methods One 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. Results Median 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 ± 7.7 kg/m 2 to 30.8 ± 5.2 kg/m 2 18 months after surgery. The percentage of excess weight lost (% 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 ± 4.3 kg/m 2) and tended to stabilize in patients with longer follow-up times. Significant nutritional deficiencies requiring replacement therapy were detected in some micronutrients with iron (42.9%), zinc (38.3%), vitamin A (55.5%), and vitamin D (57.8%) deficiencies being most relevant. Conclusions Duodenal switch is a very effective surgical procedure for treating morbidly obese patients because it allows for achieving 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.