World Journal of Surgery

, Volume 41, Issue 4, pp 927–934 | Cite as

Perioperative Risks of Dietary and Herbal Supplements

  • Ilana LevyEmail author
  • Samuel Attias
  • Eran Ben-Arye
  • Lee Goldstein
  • Ibrahim Matter
  • Mostafa Somri
  • Elad Schiff
Original Scientific Report



Patients undergoing surgery often use Dietary and Herbal Supplements (DHS). We explored the risk of DHS–drug interactions in the perioperative setting.


In this cross-sectional prospective study, participants hospitalized for surgery completed a questionnaire regarding DHS use. We used pharmacological databases to assess DHS–drug interactions. We then applied univariate and multivariate logistic regression analyses to characterize patients at risk for DHS–drug interactions.


Of 526 interviewees, 230 (44%) patients reported DHS use, with 16.5% reporting using DHS that could potentially interact with anesthesia. Twenty-four (10%) patients used DHS that could potentially interact with antithrombotic drugs taken perioperatively. The medical files of three patients included reports of intraoperative bleeding. The patient files of only 11% of DHS users documented DHS use.


DHS use poses a significant health risk due to potential interactions. Guidelines should emphasize perioperative management of DHS use.


Drug Interaction Enoxaparin Laparoscopic Sleeve Gastrectomy Medical File Antithrombotic Drug 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.



We thank Ms. Silvi Auerbach, Ms. Rita Stern, Ms. Anat Melamed, Ms. Ramzia Sarouzi, Ms. Alexandra Kamladi-nov, Ms. Shani Shitrit, Ms. Nur Zahawa, Ms. Wafa Halabi, Ms. Rana Huri, Ms. Riham Hanifes, Ms. Missa Abu-Hussein, Ms. Rachel Alberg, Ms. Meital Attias, Ms. Yulia Korshov, Ms. Dikla Cogan, Ms. Marina Ukon, Ms. Michal Fassoua, Ms. Einav Kadour, Ms. Inbal Halabi, Ms. Shlomit Grimberg, Ms. Sarah Ben Shlosh and Ms. Myriam Rosenblum for their contribution in interviewing patients; Ms. Ilana Merhav and Ms. Tanya Kligerman for their assistance in the literature search; Ms. Ronit Leiba for the statistical processing.

Compliance with ethical standards

Conflict of interest

None of the authors has a conflict of interest.


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Copyright information

© Société Internationale de Chirurgie 2016

Authors and Affiliations

  • Ilana Levy
    • 1
    Email author
  • Samuel Attias
    • 2
    • 3
  • Eran Ben-Arye
    • 4
    • 5
  • Lee Goldstein
    • 4
    • 6
  • Ibrahim Matter
    • 4
    • 7
  • Mostafa Somri
    • 4
    • 8
  • Elad Schiff
    • 1
    • 2
    • 4
  1. 1.Internal Medicine B DepartmentBnai Zion Medical CenterHaifaIsrael
  2. 2.Complementary Medicine DepartmentBnai Zion Medical CenterHaifaIsrael
  3. 3.School of Public HealthUniversity of HaifaHaifaIsrael
  4. 4.Rappaport Faculty of MedicineThe Technion-Israel Institute of TechnologyHaifaIsrael
  5. 5.Integrative Oncology Program, Oncology Service, Lin Medical CenterClalit Health ServicesWestern Galilee District, HaifaIsrael
  6. 6.Clinical Pharmacology UnitHaemek Medical CenterAfulaIsrael
  7. 7.Surgery DepartmentBnai Zion Medical CenterHaifaIsrael
  8. 8.Anesthesiology DepartmentBnai Zion Medical CenterHaifaIsrael

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