Wernicke-Korsakoff Encephalopathy Following Biliopancreatic Diversion

Primavera, A.; Brusa, G; Novello, P; Schenone, Angelo; Gianetta, Ezio; Marinari, Giuseppe M.; Cuneo, S; Scopinaro, Nicola

doi:10.1381/096089293765559548

Cited by 38 publications

(13 citation statements)

References 3 publications

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“…Beriberi has been reported following most types of restrictive [8][9][10][11][12][13] and malabsorptive [14,15] weight-loss procedures. However, there are only a few publications on thiamine status in morbidly obese patients undergoing bariatric surgery.…”

Section: Discussionmentioning

confidence: 99%

Peripheral Neuropathy and Severe Malnutrition following Duodenal Switch

et al. 2008

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Severe thiamine (vitamin B-1) deficiency is a medical emergency that has long been recognized as a potential complication of bariatric surgery. The incidence of this rare complication is largely unknown. We describe a super-obese male patient with extreme lower limb weakness 3 months following a duodenal switch operation, occurring in association with persisting vomiting. Excessive malabsorption led to severe malnutrition, with lower limb edemas and clinical evidence of ascites and pleural effusion. Blood tests revealed low levels of albumin, hemoglobin, potassium, vitamins A, B-1, and B-6, and elevated prothrombin time. The symptoms of neuropathy improved after extensive nutritional therapy. Weight eventually stabilized following elongation of the common channel. This case report demonstrates the importance of awareness of neurological complications following bariatric surgery. These complications require urgent and vigorous therapy when they occur.

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Section: Discussionmentioning

confidence: 99%

Peripheral Neuropathy and Severe Malnutrition following Duodenal Switch

et al. 2008

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“…Symptomatic thiamine deficiency has been described after a few weeks of intractable vomiting after any bariatric procedure, usually as a consequence of mechanical problems such as stoma stenosis after gastric bypass [32], excessive band tightness or band slippage after gastric banding [33] and stomach oedema with impaired nutrition after sleeve gastrectomy [34]. Cases of thiamine deficiencies have been reported also after biliopancreatic diversion [35]. Peripheral neuropathy or Wernicke's encephalopathy and Korsakoff's psychoses are the typical manifestations of thiamine deficiency [5].…”

Section: Micronutrient Supplementationmentioning

confidence: 99%

Practical Recommendations of the Obesity Management Task Force of the European Association for the Study of Obesity for the Post-Bariatric Surgery Medical Management

et al. 2017

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Bariatric surgery is today the most effective long-term therapy for the management of patients with severe obesity, and its use is recommended by the relevant guidelines of the management of obesity in adults. Bariatric surgery is in general safe and effective, but it can cause new clinical problems and is associated with specific diagnostic, preventive and therapeutic needs. For clinicians, the acquisition of special knowledge and skills is required in order to deliver appropriate and effective care to the post-bariatric patient. In the present recommendations, the basic notions needed to provide first-level adequate medical care to post-bariatric patients are summarised. Basic information about nutrition, management of co-morbidities, pregnancy, psychological issues as well as weight regain prevention and management is derived from current evidences and existing guidelines. A short list of clinical practical recommendations is included for each item. It remains clear that referral to a bariatric multidisciplinary centre, preferably the one performing the original procedure, should be considered in case of more complex clinical situations.

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“…Longer-term studies are necessary to ensure that results are enduring [59]. Clinically there have been case reports of BPD/DS-related vitamin A deficiency and associated night-blindness [60, 61], post-BPD/DS peripheral neuropathies associated with B12 deficiencies [61], and Wernicke's encephalopathy as a result of B1 deficiencies [62, 63]. …”

Section: Bpd/ds Related Complicationsmentioning

confidence: 99%

Biliopancreatic Diversion: The Effectiveness of Duodenal Switch and Its Limitations

Anderson

Gill

Gara

et al. 2013

Gastroenterology Research and Practice

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The prevalence of morbidly obese individuals is rising rapidly. Being overweight predisposes patients to multiple serious medical comorbidities including type two diabetes (T2DM), hypertension, dyslipidemia, and obstructive sleep apnea. Lifestyle modifications including diet and exercise produce modest weight reduction and bariatric surgery is the only evidence-based intervention with sustainable results. Biliopancreatic diversion (BPD) produces the most significant weight loss with amelioration of many obesity-related comorbidities compared to other bariatric surgeries; however perioperative morbidity and mortality associated with this surgery are not insignificant; additionally long-term complications including undesirable gastrointestinal side effects and metabolic derangements cannot be ignored. The overall quality of evidence in the literature is low with a lack of randomized control trials, a preponderance of uncontrolled series, and small sample sizes in the studies available. Additionally, when assessing remission of comorbidities, definitions are unclear and variable. In this review we explore the pros and cons of BPD, a less well known and perhaps underutilized bariatric procedure.

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Wernicke-Korsakoff Encephalopathy Following Biliopancreatic Diversion

Cited by 38 publications

References 3 publications

Peripheral Neuropathy and Severe Malnutrition following Duodenal Switch

Peripheral Neuropathy and Severe Malnutrition following Duodenal Switch

Practical Recommendations of the Obesity Management Task Force of the European Association for the Study of Obesity for the Post-Bariatric Surgery Medical Management

Biliopancreatic Diversion: The Effectiveness of Duodenal Switch and Its Limitations

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