Department of Surgery, Mount Sinai Health System, New York, NY, 10029, USA.
Obes Surg. 2023 Nov;33(11):3621-3627. doi: 10.1007/s11695-023-06840-8. Epub 2023 Oct 6.
Wernicke encephalopathy (WE) is an acute neurological disorder classically characterized by ataxia, ophthalmoplegia, and altered mental status. This is caused by thiamine deficiency and is usually seen in malnourished populations. However, with the advent and rise of bariatric surgery in the last 50 years, WE has become an increasingly recognized and potentially deadly complication. Here, we review the populations at risk, clinical presentation, and the incidence of WE in the bariatric surgery population from 1985 to 2023. While the predominant procedure shifts throughout the years, the overall incidence of WE per 100,000 cases for the following procedures are sleeve gastrectomy (1.06), gastric band (1.16), RYGB (4.29), and biliopancreatic diversion with duodenal switch (8.92). Thus, early intervention and post-operative supplementation is recommended to prevent WE.
威尼克脑病(WE)是一种急性神经系统疾病,其特征通常为共济失调、眼肌瘫痪和精神状态改变。该病由硫胺素缺乏引起,通常发生在营养不良人群中。然而,随着过去 50 年来减重手术的出现和兴起,WE 已成为一种日益被认识到的、可能致命的并发症。在此,我们回顾了风险人群、临床表现以及 1985 年至 2023 年减重手术人群中 WE 的发病率。虽然主导手术多年来不断变化,但以下手术的 WE 每 10 万例的发病率分别为:袖状胃切除术(1.06)、胃带术(1.16)、胃旁路术(RYGB)(4.29)和胆胰分流加十二指肠转位术(8.92)。因此,建议早期干预和术后补充以预防 WE。