Micronutrient Supplementation after Biliopancreatic Diversion with Duodenal Switch in the Long Term

Obes Surg. 2016 Oct;26(10):2469-74. doi: 10.1007/s11695-016-2132-1.


Background: 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).

Methods: 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.

Results: 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.

Conclusions: 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.

Keywords: Biliopancreatic diversion with duodenal switch; Long-term follow-up; Micronutrient supplementation; Mineral deficiency; Vitamin deficiency.

MeSH terms

  • Adult
  • Anastomosis, Surgical
  • Biliopancreatic Diversion / adverse effects*
  • Biliopancreatic Diversion / methods
  • Deficiency Diseases / blood*
  • Deficiency Diseases / etiology
  • Deficiency Diseases / therapy*
  • Dietary Supplements*
  • Duodenum / surgery
  • Female
  • Humans
  • Male
  • Micronutrients / blood
  • Micronutrients / therapeutic use*
  • Middle Aged
  • Obesity, Morbid / blood
  • Obesity, Morbid / surgery*
  • Time Factors


  • Micronutrients