Is malnutrition seen with biliopancreatic diversion

Is malnutrition seen with biliopancreatic diversion? 

• Yes. Protein has only 200 to 300 cm of ileum to be absorbed. Up to 30% of patients end up with protein-calorie malnutrition requiring hospitalization and TPN or surgical revision.
• A high-protein, lower-carbohydrate diet is required to avoid inducing a state of starvation mimicking kwashiorkor disease.

Are there other health risks associated with biliopancreatic diversion? 

• Yes. The risks are similar to gastric bypass except higher. Mortality is 1% to 2%. Leaks, obstructions, and ulcers can happen as well.
• Vitamin B ₁₂ , folate, and iron deficiency anemia are common without lifelong supplementation.
• Hypocalcemia and bone demineralization are common, leading to bone pain and osteoporosis if calcium and vitamin D are not administered in high doses lifelong.
• Patients also complain of frequent diarrhea, foul-smelling stool and flatulence, and halitosis.

Why to choose biliopancreatic diversion? 

• Aside from being the most effective weight loss and metabolic improvement procedure, patients can eat as much as they want.
• This may be the best procedure for the binge-eater or compulsive snacker who classically fails the other weight loss procedures.
• The biliopancreatic diversion has also been proven to be effective for the so-called super morbid obese (BMI ≥ 50) who may not lose as much weight with the other procedures.