title: Micronutrient Supplementation after Biliopancreatic Diversion with Duodenal Switch in the Long Term.
abstract: Malabsorptive bariatric surgery requires life-long micronutrient supplementation. Based on the recommendations, we assessed the number of adjustments of micronutrient supplementation and the prevalence of vitamin and mineral deficiencies at a minimum follow-up of 5 years after biliopancreatic diversion with duodenal switch (BPD-DS).
  
  
  
  Between October 2010 and December 2013, a total of 51 patients at a minimum follow-up of 5 years after BPD-DS were invited for a clinical check-up with a nutritional blood screening test for vitamins and minerals.
  
  
  
  Forty-three of fifty-one patients (84.3 %) completed the blood sampling with a median follow-up of 71.2 (range 60-102) months after BPD-DS. At that time, all patients were supplemented with at least one multivitamin. However, 35 patients (81.4 %) showed either a vitamin or a mineral deficiency or a combination of it. Nineteen patients (44.1 %) were anemic, and 17 patients (39.5 %) had an iron deficiency. High deficiency rates for fat-soluble vitamins were also present in 23.2 % for vitamin A, in 76.7 % for vitamin D, in 7.0 % for vitamin E, and in 11.6 % for vitamin K.
  
  
  
  The results of our study show that the prevalence of vitamin and mineral deficiencies after BPD-DS is 81.4 % at a minimum follow-up of 5 years. The initial prescription of micronutrient supplementation and further adjustments during the first follow-up were insufficient to avoid long-term micronutrient deficiencies. Life-long monitoring of micronutrients at a specialized bariatric center and possibly a better micronutrient supplementation, is crucial to avoid a deficient micronutrient status at every stage after malabsorptive bariatric surgery.
authors.affiliation: Department of Visceral Surgery and Medicine, Bern University Hospital and University of Bern, 3010, Bern, Switzerland. philipp.nett@insel.ch.
authors.forename: Philipp
authors.initials: P
authors.lastname: Nett
authors.affiliation: Department of Visceral Surgery and Medicine, Bern University Hospital and University of Bern, 3010, Bern, Switzerland.
authors.forename: Yves
authors.initials: Y
authors.lastname: Borbély
authors.affiliation: Department of Visceral Surgery and Medicine, Bern University Hospital and University of Bern, 3010, Bern, Switzerland.
authors.forename: Dino
authors.initials: D
authors.lastname: Kröll
mesh_terms: D000328:Adult; D000714:Anastomosis, Surgical; D015904:Biliopancreatic Diversion / Q000009:adverse effects* / Q000379:methods; D003677:Deficiency Diseases / Q000097:blood* / Q000209:etiology / Q000628:therapy*; D019587:Dietary Supplements; D004386:Duodenum / Q000601:surgery; D005260:Female; D006801:Humans; D008297:Male; D018977:Micronutrients / Q000097:blood / Q000627:therapeutic use*; D008875:Middle Aged; D009767:Obesity, Morbid / Q000097:blood / Q000601:surgery*; D013997:Time Factors
chemical_list: D018977:Micronutrients
keywords: Biliopancreatic diversion with duodenal switch; Long-term follow-up; Micronutrient supplementation; Mineral deficiency; Vitamin deficiency