CHOLELTHIASIS:

There is a significant increase in the percentage of patients who develop biliary lithiasis after gastric bypass. Its management varies in tendencies: from groups in which prophylactic cholecystectomy is performed to all patient’s concomitant with the bypass (even without stones); from groups in which the gallbladder is removed to those who present stones without symptoms and groups in which extraction is Nutritional alterations:

These interventions require taking preventive measures that include, for example, the measurement of vitamin levels in the preoperative period. A lot of attention should be given in the post-operative controls to fat-soluble vitamins, which should be supplemented from the postoperative period. Vitamin A and D must be monitored with special care.

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Calcium deficiency is less likely if the supplement is adequate. Special mention is made of vitamin B1 deficiency, which in extreme cases could lead to the described Wernicke-Korsakoff syndrome; if there is clinical suspicion, multivitamins rich in thiamine are indicated.

Folic acid deficiency may also occur; special emphasis is placed on patients of reproductive age subjected to procedures with a malabsorptive component because they must consume routine folic acid. Only performed at the same time if the patient is symptomatic. The results do not show evidence that any trend is better. The protocol established by each group based on their experience should be the guideline to follow.

MALABSORPTIVE POSTOPERATIVE ALTERATIONS:

In this paragraph we want to draw attention to the consequences of these interventions and the changes they produce: diarrhea, bone demineralization, some degree of protein malnutrition and predisposition to anemia, situations that are common in these patients during the postoperative period.

It can help reduce some of the risks and possible side effects as follows:

• Decreasing your body mass index (BMI)
• Increase the amount of exercise
• Give up smoking
• Our pre-surgical lifestyle program can help you prepare for bariatric surgery.