Evaluation of Long-Term Nutrition Outcomes After Duodenal Switch: A Systematic Review and Meta-Analysis.
Am Surg
; 90(3): 399-410, 2024 Mar.
Article
em En
| MEDLINE
| ID: mdl-37694730
ABSTRACT
BACKGROUND:
Biliopancreatic diversion with duodenal switch (BPD-DS) is the most effective and durable metabolic and bariatric surgery to achieve a target weight loss. However, many surgeons are hesitant to adopt BPD-DS due to a lack of training, technical complexity, and long-term nutrition deficiencies. This meta-analysis aimed to investigate long-term nutrition outcomes after primary BPD-DS in the management of obesity.METHODS:
Cochrane, Embase, PubMed, Scopus, and Web of Science were searched for articles from their inception to February 2023 by 2 independent reviewers using the Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) system. The review was registered prospectively with PROSPERO (CRD42023391316).RESULTS:
From 834 studies screened, 8 studies met the eligibility criteria, with a total of 3443 patients with obesity undergoing primary BPD-DS. At long-term follow-up (≥5 years), 25.4% of patients had vitamin A deficiency (95% CI -.012, .520, I2 = 94%), and 57.3% had vitamin D deficiency (95% CI .059, 1.086, I2 = 86%). Calcium deficiency was observed in 125 patients (22.2%, 95% CI .061, .383, I2 = 97%), and 69.7% had an abnormal parathyroid hormone level (95% CI .548, .847, I2 = 78%). Ferritin level was abnormal in 30 patients (29.0%, 95% CI .099, .481, I2 = 79%).CONCLUSIONS:
Despite displaying comparable nutrition-related outcomes to mid-term follow-up, our study demonstrated that BPD-DS could result in a high level of long-term nutrition deficiency after BPD-DS for selected patients. However, further randomized controlled studies with standardized supplementation regimens and improvement in compliance are necessary to evaluate and prevent long-term nutritional deficiencies after BPD-DS.Palavras-chave
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Obesidade Mórbida
/
Desvio Biliopancreático
/
Desnutrição
Tipo de estudo:
Clinical_trials
/
Systematic_reviews
Limite:
Humans
Idioma:
En
Revista:
Am Surg
Ano de publicação:
2024
Tipo de documento:
Article
País de afiliação:
Reino Unido