Laparoscopic Malabsorption Procedures: Postoperative Management and Nutritional Evaluation

Minimally invasive malabsorptive procedures such as the biliopancreatic diversion, developed by Scopinaro et al. (1), and duodenal switch, popularized by Marceau et al. (2) and Hess (3), are effective surgical procedures to produce permanent weight loss. However, they are technically more complex with morbidity and mortality that may exceed those seen with laparoscopic adjustable gastric band or Roux-en-Y gastric bypass (4). In addition, malabsorptive procedures carry a higher risk of nutritional abnormalities such as protein and vitamin deficiencies. Because of higher risks associated with malabsorptive procedures, the postoperative management and nutritional assessment in these patients is a lifelong commitment for both patient and surgeon.