Protein deficiency after gastric bypass: The role of common limb length in revision surgery |
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| Institution: | 1. Program for Cancer Molecular Biology and Drug Discovery, College of Medical Science and Technology, Taipei Medical University and Academia Sinica, Taipei, Taiwan, R.O.C.;2. Department of Surgery, Min-Sheng General Hospital, Taoyuan, Taiwan, R.O.C.;3. Central Clinic and Hospital, Taipei, Taiwan, R.O.C.;4. Department of International Business, Chien Hsin University of Science and Technology, Taoyuan, Taiwan, R.O.C.;1. Weight Loss and Metabolic Surgery Center, Yotsuya Medical Cube, Tokyo, Japan;2. Department of Surgery, Bhumibol Adulyadej Hospital, Royal Thai Airforce, Bangkok, Thailand;3. School of Social Welfare Tokyo University and Graduate School of Social Welfare, Tokyo, Japan;4. Weight Management and Bariatric-Metabolic Surgery Center, St. Luke''s Medical Center, Quezon City, Philippines |
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| Abstract: | BackgroundBariatric surgery, especially the gastric bypass procedure, is an effective therapy for morbid obesity, but may reduce protein absorption and induce protein deficiency (PD). A recent study reported an issue about common limb length for PD.ObjectiveThis study aimed to examine the prevalence of PD after gastric bypass surgery and investigate the role of common limb length in PD-related revision surgery.SettingHospital-based bariatric center.MethodsFrom 2001 to 2016, 2397 patients with morbid obesity who underwent bariatric/metabolic surgery with 1-year follow-up were recruited. Serum albumin and total protein were measured before and 1 year after surgery. Medical records of patients who underwent revision surgery due to PD were reviewed.ResultsThe overall prevalence of PD was .5% preoperatively. The prevalence of PD increased to 2.0% at 1 year after surgery. The incidence was highest in one-anastomosis gastric bypass (2.8%) followed by Roux-en-Y gastric bypass (1.8%). Until the end of follow-up, all 19 patients who underwent revision surgery for intractable PD had a relatively short common limb length of <400 cm. After elongation of the common limb length to >400 cm in revision surgery, PD improved in all patients.ConclusionsA subset of patients can develop PD after gastric bypass surgery when the common limb length is <400 cm. In patients with intractable PD after gastric bypass surgery, revision surgery for elongation of common limb length to >400 cm is mandatory to avoid PD-related complications. |
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