Hypocalcemia complicating near-total thyroidectomy in patients with coexisting lipid malabsorption due to biliopancreatic diversion

Melania Manco, Giuseppe Nanni, Vincenzo Tondolo, Amerigo Iaconelli, Aldo V. Greco, Marco Castagneto, Geltrude Mingrone

Research output: Contribution to journalArticlepeer-review

Abstract

Background: Patients who have undergone biliopancrealic diversion (BPD) show a high incidence of mild hypocalcemia, which may become symptomatic and life-treating after an extensive thyroid operation. Methods: 4 cases are reported of women who had undergone BPD, who subsequently underwent near-total thyroidectomy for extensive multinodular goiter. Results: The first patient developed severe symptomatic hypocalcemia with malnutrition in the long-term, that required elongation of the common limb of the BPD. The second and third patients developed severe symptomatic hypocalcemia immediately after the thyroidectomy. In the fourth patient, preventive and continuing intravenous administration of calcium gluconate was started in the early hours after the thyroidectomy and allowed a safe and fast discharge home. Conclusion: In patients who are candidates for both thyroid and bariatric surgery, surgeons should carefully evaluate the opportunity to perform the thyroidectomy first. BPD patients who later undergo thyroidectomy should be perioperatively routinely treated with intravenous calcium and, whenever appropriate, intravenous vitamin D, to allow a safe and rapid discharge.

Original languageEnglish
Pages (from-to)1429-1434
Number of pages6
JournalObesity Surgery
Volume14
Issue number10
DOIs
Publication statusPublished - Nov 2004

Keywords

  • Biliopancreatic diversion
  • Hypocalcemia
  • Hypoparathyroidism
  • Malnutrition
  • Tetany
  • Thyroidectomy

ASJC Scopus subject areas

  • Surgery

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