From the Guidelines
For patients who have undergone gastric bypass, sleeve gastrectomy, duodenal switch, and single-anastomosis duodeno-ileal (SADI) procedures, the recommended follow-up frequency for laboratory tests is every 3 months in the first postoperative year, every 6 months in the second year, and then annually. This schedule is based on the nutritional recommendations for adult bariatric surgery patients, which emphasize the importance of regular and supportive management by qualified health care professionals 1. The laboratory tests should include complete blood counts, electrolytes, lipid profile, glucose, and liver and kidney functions, as well as assessments of vitamin and mineral status.
The follow-up schedule should be tailored to the individual patient's needs, with a focus on preventing and detecting nutritional deficiencies and other potential complications of bariatric surgery. For example, patients who have undergone malabsorptive procedures such as duodenal switch and SADI-S may require more frequent monitoring of their laboratory tests, including quarterly labs in the first year and biannually thereafter. In contrast, patients who have undergone sleeve gastrectomy may require less frequent monitoring, with laboratory tests performed every 6 months and then annually.
Key components of the follow-up schedule should include:
- Regular assessments of weight and physical activity
- Monitoring of laboratory tests, including complete blood counts, electrolytes, lipid profile, glucose, and liver and kidney functions
- Assessments of vitamin and mineral status, including vitamin B12, folate, iron studies, and fat-soluble vitamins (A, E, K)
- Screening for micronutrient deficiencies, bone health, and control of nutrition-related noncommunicable diseases
- Reinforcement of healthy eating habits, such as eating slowly, portion control, and meeting protein requirements.
By following this schedule and tailoring the follow-up to the individual patient's needs, healthcare providers can help prevent and detect potential complications of bariatric surgery, improve patient outcomes, and enhance overall quality of life 1.
From the Research
Follow-up Frequency for Laboratory Tests
The recommended follow-up frequency for laboratory tests in patients who have undergone gastric bypass, sleeve gastrectomy, duodenal switch, and single-anastomosis duodeno-ileal (SADI) procedures is as follows:
- Regular blood analyses are recommended every 3 months during the first post-operative year, every 6 months the second year, and then annually 2
- Laboratory tests should be performed routinely to prevent the development of micronutrient deficiencies, with most tests recommended to be done at least once a year 3
- The frequency of laboratory testing may vary depending on the specific procedure and the patient's individual needs, with some studies suggesting that patients undergoing gastric bypass may require more frequent testing than those undergoing other procedures 3, 4, 5
Laboratory Tests to be Performed
The following laboratory tests are recommended to be performed as part of the follow-up:
- Tests for micronutrient deficiencies, such as vitamin B12, iron, and folic acid 2, 4, 5
- Complete blood counts and common metabolic panels 3
- Tests for diabetes and other metabolic disorders 3, 6
- Tests for fat-soluble vitamins, such as vitamin D 4, 5
Importance of Long-term Follow-up
Long-term follow-up with laboratory tests is essential to monitor the patient's nutritional status and prevent adverse effects, deficiencies, and metabolic improvements 3, 6
- The frequency and type of laboratory tests may need to be adjusted based on the patient's individual needs and response to treatment 6