Post-thyroidectomy Hypocalcemia in Patients With History of Bariatric Operations: Current Evidence and Management Options

Eleftherios Spartalis; Antonia Thanassa; Dimitrios I Athanasiadis; Dimitrios Schizas; Antonios Athanasiou; Georgios N Zografos; Gerasimos Tsourouflis; Dimitrios Dimitroulis; Nikolaos Nikiteas

doi:10.21873/invivo.11614

Post-thyroidectomy Hypocalcemia in Patients With History of Bariatric Operations: Current Evidence and Management Options

In Vivo. 2019 Jul-Aug;33(4):1373-1379. doi: 10.21873/invivo.11614.

Authors

Eleftherios Spartalis^#^{1

2}, Antonia Thanassa^#^{2

3}, Dimitrios I Athanasiadis⁴, Dimitrios Schizas^{2

5}, Antonios Athanasiou⁶, Georgios N Zografos³, Gerasimos Tsourouflis⁷, Dimitrios Dimitroulis^{2

7}, Nikolaos Nikiteas^{8

2}

Affiliations

¹ Laboratory of Experimental Surgery and Surgical Research N.S. Christeas, National and Kapodistrian University of Athens, Medical School, Athens, Greece eleftherios.spartalis@gmail.com.
² Hellenic Minimally Invasive and Robotic Surgery (MIRS) Study Group, Athens, Greece.
³ Third Department of Surgery, Athens General Hospital "Georgios Gennimatas", Athens, Greece.
⁴ Department of Surgery, Indiana University School of Medicine, Indianapolis, IN, U.S.A.
⁵ 1st Department of Surgery, National and Kapodistrian University of Athens Medical School, Athens, Greece.
⁶ Department of Upper GI, Bariatric & Minimally invasive Surgery, St. James' University Hospital, Leeds Teaching Hospitals NHS Trust, Leeds, U.K.
⁷ 2nd Department of Propaedeutic Surgery, National and Kapodistrian University of Athens Medical School, Athens, Greece.
⁸ Laboratory of Experimental Surgery and Surgical Research N.S. Christeas, National and Kapodistrian University of Athens, Medical School, Athens, Greece.

^# Contributed equally.

Abstract

Background/aim: Both bariatric and thyroid surgeries promote calcium and vitamin D deficiency. The correlation, however, of hypocalcemia after thyroidectomy in patients with previous bariatric surgery has been poorly described. This review aimed to investigate the relationship between history of bariatric operations and post-thyroidectomy hypocalcemia, as well as suggested management options.

Materials and methods: MEDLINE and Cochrane databases were searched for relevant publications regarding post-thyroidectomy hypocalcemia in patients with previous bariatric surgery.

Results: A total of 17 publications reporting on 126 patients met the inclusion criteria. These included 13 publications about Roux-en-Y gastric bypass (RYGB), 2 regarding biliopancreatic diversion (BPD), 1 about sleeve gastrectomy (SG) and 1 compared three bariatric procedures: SG, RYGB, laparoscopic adjustable gastric band (LAGB). Post-thyroidectomy hypocalcemia was found to be more prevalent in patients with previous RYGB and BPD, but not in previous LAGB and SG.

Conclusion: Patients with previous bariatric surgery are at high risk of post-thyroidectomy hypocalcemia that sometimes leads to higher length of hospital stay and demands more invasive solutions. There is a need, however, for additional studies and further investigation in order to reach more conclusive results.

Keywords: Bariatric surgery; hypocalcemia; review; thyroid surgery; thyroidectomy.

Publication types

Meta-Analysis

MeSH terms

Bariatric Surgery / adverse effects*
Clinical Decision-Making
Disease Management
Female
Humans
Hypocalcemia / diagnosis
Hypocalcemia / epidemiology
Hypocalcemia / etiology*
Male
Postoperative Complications*
Risk
Thyroidectomy / adverse effects*
Thyroidectomy / methods