Page 27 - WJOLS - Journal of Laparoscopic Surgery

WJOLS

Pallikonda S Madhulika, Juan González-Tova 10.5005/jp-journals-10033-1317
REVIEW ARTICLE

Hypocalcemia and Vitamin D Deficiency in Patients

Post-bariatric Surgery: A Systematic Review

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1 Pallikonda S Madhulika, Juan U González-Tova

ABSTRACT INTRODUCTION

Introduction: Bariatric surgery is viewed as the best tool Since the advent of bariatric surgery, numerous surgical
for the control and treatment of severe obesity; however, techniques for the treatment of obesity have been proposed
postsurgery, they have a greater risk of developing nutritional and further improvised over the decades. The RYGB is an
deficiencies as this procedure hinders the absorption of most
of the nutrients. operation, i.e., viewed as a gold standard of treatment for
extreme obesity in light of the fact that it results in fewer
Objective: To evaluate the effect of vitamin D insufficiency serious side effects and complications than conventional
and that of calcium in bone in patients after Roux-en-Y gastric malabsorption techniques, e.g., jejunoileal bypass. The
1-3
bypass (RYGB), and the mode of administration of calcium, its
dosage, and efficacy. malabsorption methodologies have been perceived as a
4-8
risk factor for diseases of bone because of the resulting
Materials and methods: A precise survey was performed with alteration of calcium metabolism and decreased absorp-
articles identified that are associated with the subject of interest. tion. 9-15 Some studies explored these deranged levels of
Articles from 10 years back were looked up in PubMed, the US
National Library of Medicine, the National Institutes of Health, calcium tentatively in patients with jejunoileal bypass,
Medline, Lilacs, Scielo, and Cochrane utilizing the headings and demonstrated that assimilation diminishes by half
“bariatric surgery,” “bone,” “obesity,” “vitamin D,” “calcium,” and after surgery. 10,11,14 Insufficient calcium intake is common
“absorption.” after gastric bypass, 16,17 further increasing the bone loss.

Results: Five articles were incorporated into this survey Comprehending the postoperative RYGB, diminishing of
that have analyzed the facts that bariatric surgery can cause calcium absorption and supplements, and exploring the
wholesome inadequacies of nutrition and poor assimilation dosages, modes of administration, and the duration of
of fats and fat-dissolvable vitamins and micronutrients, e.g., medication treatment and its impacts on bone were the
calcium. sole objectives of this review.
Conclusion: Patients submitted to RYGB should make use of
multivitamins and minerals, especially vitamin D and calcium MATERIALS AND METHODS
to prevent bone fractures. Monitoring, treatment, and control The population, intervention, comparison, and outcome
of risk factors are essential to prevent complications after this (PICO) strategy was adopted to expound the response to
operation.
the question, “How is bone lost in patients who experience
Keywords: Bariatric surgery, Calcium deficiency, Vitamin D bariatric surgery and what supplements help to diminish
deficiency. this loss?” Obese patients who had bone loss and addition-
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How to cite this article: Madhulika PS, González-Tova JU. ally BMI from 35 to 39.9 kg/m with comorbidities and ≥40
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Hypocalcemia and Vitamin D Deficiency in Patients Post- kg/m (population); patients submitted to RYGB by lapa-
bariatric Surgery: A Systematic Review. World J Lap Surg roscopy or laparotomy (intervention); eutrophic patients
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2017;10(3):108-111. with BMI of 18.5 to 24.9 kg/m (comparison); patients with
Source of support: Nil insufficiency of vitamin D and calcium and conceivable
nearness of fractures (outcome) were selected.
Conflict of interest: None
Qualification Criteria for Study Consideration

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1 Assistant Professor, Professor Inclusion Criteria
1 Department of General Surgery, Shri Sathya Sai Medical All studies; patients of age 15 to 70 years; BMI from 35 to
2
2
College and Research Institute, Chennai, Tamil Nadu, India 39.9 kg/m with comorbidities and ≥40 kg/m ; ≥3 months
2 Department of Urology, Hospital Universitari de Vic, Barcelona postsurgery; and laparoscopic or laparotomic RYGB.
Spain
Exclusion Criteria
Corresponding Author: Pallikonda S Madhulika, Assistant
Professor, Department of General Surgery, Shri Sathya Sai Pregnant women or, women in lactation; smoking or
Medical College and Research, Institute Chennai, Tamil Nadu previous smoker; people treated with bisphosphonates;
India, e-mail: juan.uriagt@gmail.com
and animals.
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