Complications, Mineral and Vitamin Deficiencies: Comparison between Roux-en-Y Gastric Bypass and Sleeve Gastrectomy

Abstract

Objective: Nutritional deficiencies are known side-effects of bariatric surgeries, specifically in those that bypass the proximal intestine. Therefore, in clinical practice, vitamin and mineral supplementations are often necessary after such operations. It was our intention to evaluate, whether alimentary deficiencies occur with the same frequency in patients following Sleeve-Gastrectomy (SG) compared to Roux-en-Y Gastric Bypass (RYGB) surgeries. Methods: We conducted a retrospective data analysis of 171 patients (121 RYGB, 50 SG). Vitamin levels were compared between SG and RYGB patients over the first post-operative year. Furthermore, regression analysis was performed with regard to vitamin and iron supplementations and their recommended dosages. Complications occurring within the first post-surgical year were documented as well. Results: Other than vitamin B6 deficiency, which was found to be more frequent in SG patients, there was no other significant difference regarding the type of operation and the number of patients who had these deficiencies. There was no significant difference in average vitamin and iron levels between RYGB and SG. A minimum dose of 1000 IU vitamin D per day was necessary to affect vitamin D levels. The intramuscular administration of vitamin B12 was the only route found to be effective. Complications within the first year were rare. Conclusions: Against common assumptions, vitamin and iron deficiencies in SG patients are not less frequent in the first post-surgical year in comparison to RYGB patients. Standard supplementations should include iron in premenopausal women: Vitamin D at least 1000 IU per day and vitamin B12 i.m. administration in case of a deficiency.