Hypocalcemia after thyroidectomy in patients with a history of bariatric surgery

Chéreau, Nathalie; Vuillermet, Cindy; Tilly, Camille; Buffet, C; Trésallet, Christophe; Montcel, Sophie Tezenas du; Ménégaux, Fabrice

doi:10.1016/j.soard.2016.09.026

Cited by 27 publications

(20 citation statements)

References 23 publications

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“…In addition, depending on the type of bariatric operation there are different consequences on the vitamin D levels. As observed from other studies, RYGB and BPD operations, due to their nature, further decrease the intestinal absorption of vitamin D (2,3,36) and that of calcium (21). However, there seems to be no difference in the absorption of any other nutrient between RYGB and other bariatric operations such as GS (37).…”

Section: Discussionmentioning

confidence: 60%

“…In addition, even though hypocalcemia following thyroidectomy is a very common complication, its prevalence gets even higher in patients with previous bariatric surgery (14,21).…”

Section: Discussionmentioning

confidence: 99%

“…Calcium citrate is argued to have better absorption than calcium carbonate due to the existing low gastric acid in the stomach (27) and low calcitriol in bariatric patients. Upgrading treatment options should only be considered after giving the highest oral dose of calcium and vitamin D, because the hypocalcemia seen in these patients often completely resolves by increasing the dose (7,21). Low levels of magnesium also need to be restored because when severely depleted, they can reduce the PTH secretion (8,16).…”

Section: Discussionmentioning

confidence: 99%

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Post-thyroidectomy Hypocalcemia in Patients With History of Bariatric Operations: Current Evidence and Management Options

Spartalis

Thanassa²,

Athanasiadis

et al. 2019

In Vivo

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Background/Aim: Both bariatric and thyroid surgeries promote calcium and vitamin D deficiency. The correlation, however, of hypocalcemia after thyroidectomy in patients with previous bariatric surgery has been poorly described. This review aimed to investigate the relationship between history of bariatric operations and post-thyroidectomy hypocalcemia, as well as suggested management options. Materials and Methods: MEDLINE and Cochrane databases were searched for relevant publications regarding postthyroidectomy hypocalcemia in patients with previous bariatric surgery. Results: A total of 17 publications reporting on 126 patients met the inclusion criteria. These included 13 publications about Roux-en-Y gastric bypass (RYGB), 2 regarding biliopancreatic diversion (BPD), 1 about sleeve gastrectomy (SG) and 1 compared three bariatric procedures: SG, RYGB, laparoscopic adjustable gastric band (LAGB). Post-thyroidectomy hypocalcemia was found to be more prevalent in patients with previous RYGB and BPD, but not in previous LAGB and SG. Conclusion: Patients with previous bariatric surgery are at high risk of post-thyroidectomy hypocalcemia that sometimes leads to higher length of hospital stay and demands more invasive solutions. There is a need, however, for additional studies and further investigation in order to reach more conclusive results. Obesity has become a common health problem in western countries (1) and bariatric surgery is one of the most effective therapies for these patients. This procedure reduces the metabolic risk factors in morbidly obese patients and directly results in adequate weight loss. The most popular bariatric surgeries are Roux-en-Y gastric bypass (RYGB), sleeve gastrectomy (SG), biliopancreatic diversion (BPD) and laparoscopic adjustable gastric band (LAGB) (2, 3). Sleeve gastrectomy and the adjustable gastric band are restrictive procedures while the other two are malabsorptive ones. Although very advantageous, bariatric surgery causes vitamin and mineral deficiencies, including that of calcium and vitamin D, leading to hypocalcemia (4). On the other hand, hypocalcemia is a common complication of thyroid surgery (5). Thus, as the number of post-gastric bypass patients increases, it is expected that an increased number of patients will be diagnosed with thyroid pathology requiring thyroid surgery. This combination of a 1373 This article is freely accessible online.

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Section: Discussionmentioning

confidence: 60%

“…In addition, even though hypocalcemia following thyroidectomy is a very common complication, its prevalence gets even higher in patients with previous bariatric surgery (14,21).…”

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Post-thyroidectomy Hypocalcemia in Patients With History of Bariatric Operations: Current Evidence and Management Options

Spartalis

Thanassa²,

Athanasiadis

et al. 2019

In Vivo

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“…This case demonstrates novel management of rare, but serious, refractory hypocalcemia in patients undergoing parathyroid and thyroid surgery following RYGB. Initial management involves aggressive calcium repletion which often necessitates prolonged hospital stays [3][4][5][6]. In cases where conservative management fails, reversal of RYGB has been reported in the literature [7,8].…”

Section: Discussionmentioning

confidence: 99%

Recalcitrant Hypocalcemia in Roux-en-Y Gastric Bypass Patients After Parathyroidectomy: Successful Management With Gastrostomy Tube Placement

Hayes¹,

Tan²,

Feczko³

et al. 2018

AOHNS

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“…In the matched pair analysis, the risk of hypocalcemia was significantly higher in patients with previous bariatric surgery than in the matched cohort. The authors concluded that patients with previous bariatric surgery, especially after Roux‐en‐Y gastric bypass, have an increased risk for hypocalcemia after total thyroidectomy …”

Section: Methodsmentioning

confidence: 99%

Thyroidectomy in patients who have undergone gastric bypass surgery

et al. 2018

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Hypocalcemia after thyroidectomy in patients with a history of bariatric surgery

Cited by 27 publications

References 23 publications

Post-thyroidectomy Hypocalcemia in Patients With History of Bariatric Operations: Current Evidence and Management Options

Post-thyroidectomy Hypocalcemia in Patients With History of Bariatric Operations: Current Evidence and Management Options

Recalcitrant Hypocalcemia in Roux-en-Y Gastric Bypass Patients After Parathyroidectomy: Successful Management With Gastrostomy Tube Placement

Thyroidectomy in patients who have undergone gastric bypass surgery

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