Incidence of Vitamin B1 (Thiamine) Deficiency Post Mini-Gastric Bypass: A Prospective Study

Abstract Background: Laparoscopic Mini-Gastric Bypass is con-sidered as a restrictive & mal-absorptive technique with excision of most of the stomach plus bypassing about 2 meters of small intestine including (duodenum and jejunum). The main complication is the Vitamins and micronutrients defi-ciency as Thiamine (vit. B1). These deficiencies caused by many causes as mal-absorption withMini Gastric Bypassdue to bypassing the site of thiamine absorption. Aim of Study: The study aims to determine the impact of Mini-Gastric Bypass on thiamine (vit. B1) absorption and deficiency. Patients and Methods: A Prospective study was included 15 patients presented for Mini-Gastric Bypass Surgery At Ain Shams Hospitals and Kafr El Sheikh General Hospital from October 2020 to October 2021. Clinical history was obtained that included demographic data, history of pre-operative vitamin deficiency and comorbid diseases. Diagnosis of Thiamine deficiency was by measuring thiamine at 3 and 6 months postoperative. All patients had performed Mini-Gastric Bypass operation with intraoperative parameters: Bilio-Pancreatic limb of 2 meters is bypassed. Patients postoperatively were ensured for daily supplement of oral thiamine. Results: The mean age of the studied group was 35 years. (55%) of them were females and (45%) males. The mean BMI was 40 kg/M2 . No one of the study cases had thiamine deficiency preop-erative, all showed normal total thiamine level (3.2-9.5ug/dl). The results postoperative show 100% of cases show deficiency in total thiamine level 3 & 6 months postoperative. The Mean Excess Weight Loss percentage (EWL%) shows increase in loss about 36%, 56%, 3 & 6 months postoperatively respectively. Conclusion: Mini-Gastric Bypass is an effective operation in losing weight in the first postoperative months, despite of that is corresponding early significant deficiency of thiamine (Vit. B 1), one of the most important vitamins for energy and neurological integrity.
Deficiency of thiamine may show neurological deficits symptoms early in first 6 months postoperative.