An audit to determine if vitamin b12 supplementation is necessary after sleeve gastrectomy

Abstract

Sleeve gastrectomy has increased in popularity over the last five years and it is likely to supersede gastric banding. Nevertheless, it is unclear whether vitamin B12 supplementation is required after surgery. The aim of this short report is to identify any vitamin B12 deficiency and highlight the necessity of post laparoscopic sleeve gastrectomy vitamin B12 monitoring.Patients and methodsA review of 66 patients underwent LSG in our institution. 25 patients were excluded as they had no postoperative vitamin B12 screening. 41 patients were included as screened for vitamin B12 and other micronutrients including selenium, serum folate, ferritin, iron, zinc, copper, magnesium and vitamin D.ResultThere were 5 male (12%) and 36 females (88%), 8/41 patients (20%) had Vitamin B12 deficiency, none of them developed macrocytic anaemia. 17/21 (81%) patient were vitamin D deficient and 9/21 (43%) exhibited low selenium.ConclusionIn this small group, a 20% prevalence of vitamin B12 was identified. As a consequence vitamin B12 monitoring and supplementation will be a standard of care in the early postoperative period after LSG at this institution.

Nutritional deficiencies in pregnancy after surgery for morbid obesity

“…Moreover, there is another study which has reported that in 41 patients having udergone BS, vitamin B12 deficiency was 20% post-operatively [22] . In addition,…”

“…Its preoperative prevalence ranges between 3-18% [22][23][24][25]. After bariatric surgery the absorption of the B12 may be impaired at different levels depending on the type of procedure.…”

“…Studies have shown a decrease at the level of selenium after RYGBP. One study also reported that 9 out of 21 patients (43%) suffered from selenium deficiency after VSG [22] . Moreover, Pech et al, found that in 100 individuals who underwent VSG, a significant decrease in serum selenium levels occurred three months after the procedure and 8 out of 82 (9,7%) patients suffered from selenium deficiency and were therefore given supplementation [22] Freely [80].…”

“…al. study in which they found that there was no deficiency in 41 patients after VSG [22]. Although it is uncommon, clinicians should be vigilant in its early detection as iron and copper deficiency often coexist, especially in pregnancy.…”

“…One study, found that magnesium deficiency was present in 3% of 200 subjects having undergone BS (versus 2% preoperatively) one year after the procedure [17] . Furthermore, there are two different studies which agree that magnesium deficiency did not occur after BS [19,22] Nevertheless, further studies should investigate the impact of Mg deficit in fetuses.…”