Required Commitment for Duodenal Switch Surgery

Posted On : June 21, 2020

Written by Ara Keshishian, MD, FACS, FASMBS
Last updated: June 21, 2020

All weight loss surgical procedures require commitment for the procedure to be successful and Duodenal Switch surgery is no exception. Unlike some surgeries, Duodenal Switch has proven to be a superior weight loss surgery option with the highest documented results in long-term excess weight loss maintenance. [51] However, the success for the patient does not end with the surgery alone. To maintain proper health, patients are committed to life long of daily vitamin and mineral supplements. Another requirement is having routine blood work checked yearly at minimum as well as other diagnostic and surveillance studies, such as a bone scan, may be required. To assure a long-term success of the weight loss surgical procedure maintenance of a high protein diet with a brisk level of activity must be maintained. With the D.S., the aim should be to consume 80-100 grams of protein for 24-28 months, to minimize the muscle wasting associated with rapid weight loss.

Commitment for All DS Patients:

1) You MUST take your vitamin and mineral supplements DAILY. 2) You MUST have blood labs done and a regular follow up with your surgeon for monitoring mineral and vitamin levels. 3) You MUST have a bone density scan done every year or two years to ensure that there is a good calcium blood level and is not the result of your body leaching calcium from your bones. 4) You MUST consume 80-100 g of protein every day, either through food or protein supplements for the first 18-24 months. Long term, protein should be emphasized, and carbohydrates and fats be limited. As with all weight loss surgical procedures, Patients who choose to have the DS and do not follow with the principals above are bound to find themselves experiencing long-term complications of malnutrition, and other gastrointestinal issues. Some of the complications may result in irreversible injury, organ failures, and/or even death. There are post-op weight loss surgery patients (this is not unique to D.S. and includes RNY patients) who lost all their teeth due to calcium and vitamin D deficiency while others developed osteoporosis. There have been patients who have permanent vision impairment and balance issues due to ignoring B1 deficiencies. There are patients that ignored B12 deficiencies and suffer very serious neurological impairment. You can’t ignore your vitamins, THEY ARE NOT OPTIONAL. It is also critical to understand that vitamin and mineral deficiencies develop over long periods of time. A non-compliant patient may get a false sense of security because they do not feel any different for a few months. Later on the clinical deficiencies will surface with some of the symptoms outlined above. Correcting the deficiencies will take a long time, and in some cases the impairments may not resolve even when the laboratory studies show normalized vitamin and mineral levels.

Potential Mineral and Vitamin Deficiencies and their presenting symptoms are all discussed here.