Newbury Leyanne, Dolan Kevin, Hatzifotis Michael, Low Nadeen, Fielding George
Department of Nutrition and Dietetics, Royal Brisbane Hospital, Herston, Brisbane, Australia.
Obes Surg. 2003 Dec;13(6):893-5. doi: 10.1381/096089203322618722.
Biliopancreatic diversion (BPD) is associated with a 70% excess weight loss (EWL) at 10 years, but there are concerns regarding long-term nutritional sequelae. Metabolic bone disease has been documented following Roux-en-Y gastric bypass.
Patients who underwent a BPD from 1998 to 2001 were studied. A questionnaire was designed to review BPD patients and collect information on weight loss, frequency of gastrointestinal disturbances and compliance with multivitamin recommendations. The review included a blood test for vitamin D, parathyroid hormone (PTH), alkaline phosphatase (ALP) and calcium.
Of the 82 patients who underwent BPD during this period, the median %EWL at 36 months was 73.0%. 75.6% suffered diarrhea. At median follow-up of 32 months (18-50), 25.9% of patients were hypocalcemic, 50% had low vitamin D, 23.8% had elevated ALP, and 63.1% had elevated PTH, despite 82.9% taking multivitamins.
BPD results in significant weight loss. However, 1 in 4 patients are hypocalcemic, and 1 in 2 have a low vitamin D, despite multivitamin supplementation. BPD patients require routine calcium and vitamin D supplementation for life. Long-term sequelae from these abnormal serum levels are not known.
胆胰分流术（BPD）在10年时可带来70%的超重减轻（EWL），但人们对其长期营养后遗症存在担忧。Roux-en-Y胃旁路术后已记录到代谢性骨病。
对1998年至2001年接受BPD手术的患者进行研究。设计了一份问卷来评估BPD患者，并收集有关体重减轻、胃肠道紊乱频率以及对复合维生素建议的依从性的信息。该评估包括对维生素D、甲状旁腺激素（PTH）、碱性磷酸酶（ALP）和钙的血液检测。
在此期间接受BPD手术的82例患者中，36个月时的EWL中位数为73.0%。75.6%的患者出现腹泻。在中位随访32个月（18 - 50个月）时，尽管82.9%的患者服用复合维生素，但25.9%的患者血钙过低，50%的患者维生素D水平低，23.8%的患者ALP升高，63.1%的患者PTH升高。
BPD可导致显著的体重减轻。然而，尽管补充了复合维生素，仍有四分之一的患者血钙过低，二分之一的患者维生素D水平低。BPD患者需要终身常规补充钙和维生素D。这些异常血清水平的长期后遗症尚不清楚。
