Abnormal calcium, 25(OH)vitamin D, and parathyroid hormone after biliopancreatic diversion; correction through elongation of the common tract and reduction of the gastric pouch
| Autor: | Francesco Cetta, Antonio E. Pontiroli, Ferdinando Pinna, Valerio Ceriani |
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| Rok vydání: | 2015 |
| Předmět: |
Adult
Male Reoperation medicine.medical_specialty Malabsorption Gastroplasty chemistry.chemical_element Parathyroid hormone 030209 endocrinology & metabolism Calcium 03 medical and health sciences chemistry.chemical_compound 0302 clinical medicine Postoperative Complications Malabsorption Syndromes Weight loss mental disorders Weight Loss medicine Vitamin D and neurology Humans Vitamin D Biliopancreatic Diversion Serum Albumin Calcium metabolism Creatinine Analysis of Variance business.industry medicine.disease Surgery Obesity Morbid chemistry Parathyroid Hormone Case-Control Studies 030211 gastroenterology & hepatology Female medicine.symptom business |
| Zdroj: | Surgery for obesity and related diseases : official journal of the American Society for Bariatric Surgery. 12(4) |
| ISSN: | 1878-7533 |
| Popis: | Background Biliopancreatic diversion (BPD) is a surgical technique burdened, in some instances, by clinical evidence of malabsorption and intractable diarrhoea. Objectives To compare calcium metabolism together with weight in patients undergoing BPD versus BPD followed by revisional surgery because of side effects of BPD or ineffectiveness of BPD. Setting University hospital. Methods Twenty-seven patients underwent BPD. After a median period of 48 months, they underwent revisional surgery (elongation of the common limb from 50 to 200 cm and reduction of the gastric pouch from 500 to 40 mL) and were observed for a total period of 120 months; 40 patients only underwent BPD (controls) and were observed for an identical period. Results At baseline, 24 patients (8 revisional surgery and 16 controls) had increased parathyroid hormone (PTH) levels, and only 3 patients had normal 25(OH)vitamin D levels; calcium declined, even within normal limits, and PTH increased in the revisional surgery group. After revisional surgery, patients experienced a further decrease of weight, together with a reduction of PTH levels, an increase of 25(OH)vitamin D levels, and an increase of calcium levels. Weight loss was inverserly associated with an increase of 25(OH)vitamin D and directly associated with change of PTH. Conclusion This study suggests that it is possible to control effects of BPD on calcium metabolism through a revisional procedure leading to lesser malabsorption and to greater restriction of the gastric pouch. It should be considered in the presence of significant side effects due to excessive malabsorption. |
| Databáze: | OpenAIRE |
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