Obesity Surgery

, Volume 20, Issue 4, pp 447–453 | Cite as

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

  • Simone Gehrer
  • Beatrice Kern
  • Thomas Peters
  • Caroline Christoffel-Courtin
  • Ralph Peterli
Clinical Report



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.


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%.


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.


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.


Laparoscopic sleeve gastrectomy Laparoscopic gastric bypass Morbid obesity Nutrient deficiencies Prospective comparison 


Conflict of Interest/Disclosure

All authors declare that they have no conflict of interest. PD Dr. R. Peterli is a consultant for Ethicon Endo Surgery.

Financial Support



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Copyright information

© Springer Science + Business Media, LLC 2010

Authors and Affiliations

  • Simone Gehrer
    • 1
  • Beatrice Kern
    • 1
  • Thomas Peters
    • 2
  • Caroline Christoffel-Courtin
    • 2
  • Ralph Peterli
    • 1
  1. 1.Department of SurgerySt. ClaraspitalBaselSwitzerland
  2. 2.Interdisciplinary Center of Nutritional and Metabolic DiseasesSt. ClaraspitalBaselSwitzerland

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