200 patients after Roux-en-Y gastric bypass were nutritionally followed for an average of 6.7 years. They were randomly selected out of 450 patients operated on during 1980-1985. They had lost a mean of 56 +/- 22% of their excess weight and had remained stable in weight for the preceding 5 years with limited nutritional caloric restriction. Iron saturation, hemoglobin and mean corpuscular volume declined gradually and significantly (p less than 0.0001, p less than 0.0001 and p less than 0.001, respectively). However, mean serum concentration of vitamin B12, which also had decreased significantly during the preceding 5 years (p less than 0.0004), increased during recent years, but still was lower than before the bypass. Albumin and transferrin levels remained normal. There was no correlation between weight change and serum concentration of iron or vitamin B12. We conclude that 6.7 years after surgery, while there is no caloric or protein deficiency, there has been gradual development of iron deficiency, but not correlated with weight loss.
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Ann Intern Med
January 2025
Department of Research and Evaluation, Kaiser Permanente Southern California, Pasadena, California (A.B., K.J.C., A.A.K.).
Background: Roux-en-Y gastric bypass (RYGB) and sleeve gastrectomy (SG) differ in their effects on body weight and risk for reoperation. However, it is unclear whether long-term health expenditures differ by procedure type in patients with diabetes.
Objective: To compare health expenditures 3 years before and 5.
Endocrinol Diabetes Metab Case Rep
January 2025
Summary: Oral levothyroxine (LT4) is prescribed worldwide for hypothyroidism. Bariatric surgery for patients with obesity has shown a substantial, long-term weight loss and considerable improvement of obesity-related diseases. LT4 malabsorption represents a significant cause of refractory hypothyroidism, well known after malabsorptive bariatric surgery such as Roux-en-Y gastric bypass.
View Article and Find Full Text PDFRadiol Case Rep
March 2025
Department of Medical Imaging, Gold Coast University Hospital, 1 Hospital Blvd, Southport, Queensland 4215, Australia.
Following gastrojejunostomy in Roux-en-Y gastric bypass (RYGB), the mesentery is susceptible to Petersen's hernia due to a mesenteric gap created between the alimentary limb, transverse mesocolon, and retroperitoneum. Although the Petersen's hernia is a rare complication, it has increased due to the widespread adoption of gastric bypass surgeries for weight management and gastric cancer resections. Computed tomography (CT) is commonly used to evaluate suspected cases.
View Article and Find Full Text PDFBackground: Apart from massive weight loss, metabolic and bariatric surgery, especially gastric bypass (Roux-en-Y gastric bypass [RYGB]), can cause nutritional deficiencies. Proton pump inhibitors (PPI), relatively often used after RYGB, are associated with reduced calcium absorption. We have studied the long-term impact of PPI upon calcium homeostasis among RYGB patients.
View Article and Find Full Text PDFClinics (Sao Paulo)
January 2025
Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (HCFMUSP), São Paulo, SP, Brasil.
Background: Individuals with severe obesity and type 2 diabetes mellitus have reduced secretion of incretins by L cells. Studies suggest an increase in L cell activity according to the length of the Biliopancreatic Loop (BPL).
Objective: Compare the effect of biliopancreatic loop extension on the number and expression of L cells in patients undergoing RYGB METHODS: Subjects (n = 13) undergoing RYGB with a BPL of 100 cm (G1) or 200 cm (G2).
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