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Vitamin and Mineral Deficiencies After Biliopancreatic Diversion and Biliopancreatic Diversion with Duodenal Switch—the Rule Rather than the Exception

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Abstract

Introduction

Malabsorptive bariatric procedures, like the biliopancreatic diversion (BPD) and BPD with duodenal switch (BPD/DS), have excellent results in terms of weight loss. However, these malabsorptive techniques are associated with severe malnutrition and vitamin deficiencies. The aim of this study was to evaluate the vitamin and mineral status after BPD and BPD/DS in the long term.

Methods

All patients who underwent BPD or BPD/DS were selected and invited for an additional follow-up (FU) visit, including blood sampling for vitamin and mineral levels.

Results

Forty patients completed the blood sampling with a median FU of 42 (range 12–90) months. At that time, all patients used some kind of supplementation. However, 93 % of all patients were diagnosed with a deficiency. There were no significant differences in mean serum level vitamins and minerals between BPD and BPD/DS. Forty-three per cent of the patients were anaemic, and 40 % had an iron deficiency (ID). High deficiency rates for fat-soluble vitamins were present: vitamin A in 28 %, vitamin D in 60 %, vitamin E in 10 % and vitamin K in 60 % of the patients. Hypervitaminosis was found in 43 % of the patients for vitamin B1 and in 50 % for vitamin B6.

Conclusion

High numbers of vitamin and mineral deficiencies were found after BPD and BPD/DS despite vitamin supplementation. Anaemia, ID and deficiencies for fat-soluble vitamins are frequently diagnosed. Repeated monitoring is necessary to detect deficiencies at an early stage. Taking all of this into consideration, a stringent multivitamin supplementation regimen should be implemented after malabsorptive procedures.

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Conflict of Interest

J. Homan, B. Betzel, E.O. Aarts, K. Dogan, C.J.H.M. van Laarhoven, I.M.C. Janssen and F.J. Berends have no conflict of interests to declare.

Funding

This study was not funded.

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Authors and Affiliations

  1. Department of Surgery, Rijnstate Hospital, Postal number 1190, 6800 TA, Arnhem, The Netherlands

    Jens Homan, Bark Betzel, Edo O. Aarts, K. Dogan, Ignace M. C. Janssen & Frits J. Berends

  2. Department of Surgery, Radboud University Medical Centre, Nijmegen, The Netherlands

    Kees J. H. M. van Laarhoven

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  1. Jens Homan
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  2. Bark Betzel
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  3. Edo O. Aarts
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  4. K. Dogan
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  5. Kees J. H. M. van Laarhoven
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  6. Ignace M. C. Janssen
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  7. Frits J. Berends
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Correspondence to Jens Homan.

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Homan, J., Betzel, B., Aarts, E.O. et al. Vitamin and Mineral Deficiencies After Biliopancreatic Diversion and Biliopancreatic Diversion with Duodenal Switch—the Rule Rather than the Exception. OBES SURG 25, 1626–1632 (2015). https://doi.org/10.1007/s11695-015-1570-5

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  • DOI: https://doi.org/10.1007/s11695-015-1570-5

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