الفهرس | Only 14 pages are availabe for public view |
Abstract Malnutrition is a significant risk associated with all bariatric procedures, which can lead to dangerous nutritional deficiencies. However, if correct patient selection is conducted and if patients receive thorough preoperative nutrition education and postoperative nutritional follow-up, these deficiencies are largely preventable, and with appropriate supplementation and patient compliance, all nutritional deficiencies can be avoided or corrected. The Roux-en-Y gastric bypass (RYGBP) and mini-gastric bypass are common surgical weight loss operations. These surgeries induce weight loss by a combination of restriction and malabsorption. Despite the desired weight loss achieved with these operations, postoperative deficiencies in protein, iron, and other vitamins and minerals are common and require supplementation to maintain normal levels. Deficiencies mostly occur from malabsorption secondary to bypassing segments of gastrointestinal tract, where the various nutrients are absorbed. Gastric bypass surgery not only induce significant and durable weight loss but also determine amelioration or resolution of comorbid disease states, especially type 2 diabetes mellitus. Sustained normal concentrations of plasma glucose, insulin, and glycosylated hemoglobin have been reported in 80% to 100% of morbidly obese diabetic patients managed surgically by gastric bypass surgery. Long-term control of glycemia and normal levels of glycosylated haemoglobin have been documented in series with up to 14 years of follow-up. These surgeries seems also to restore insulin sensitivity, prevent the progression from impaired glucose tolerance to diabetes, and reduce mortality from diabetes mellitus. |