ArticleAnnals of surgical oncology2026
Hypocalcemia After Cervical Procedures in Patients with a History of Nonbariatric Gastrojejunostomy.
Article in Annals of surgical oncology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundHypocalcemia is common after cervical procedures. Patients who have undergone Roux-en-Y gastric bypass (RYGB) experience increased risk for post-thyroidectomy hypocalcemia. This association has not been elucidated for nonbariatric operations that bypass the duodenum.
methodsA multi-institutional retrospective cohort study included patients who underwent parathyroidectomy and/or thyroidectomy with prior sleeve gastrectomy (SG), bariatric RYGB, or nonbariatric gastrojejunostomy (GJ). The primary outcomes were early (≤6 months) and late (>6 months) postoperative hypocalcemia. The secondary outcomes were prolonged length of stay (>24 hours) and 30-day readmission.
resultsA total of 241 patients had prior SG (39%), RYGB (44%), or GJ (17%). Early (54%) and late (41%) hypocalcemia were common. Patients with prior GJ compared with SG had significantly higher rates of early hypocalcemia (64% vs. 44% p = 0.04). The rate of late hypocalcemia was higher in those with prior GJ (53%, p = 0.007) or RYGB (49%, p = 0.003) compared with SG (28%). By multivariable regression, early hypocalcemia was positively associated with parathyroid autotransplantation (odds ratio [OR] 6.36, p = 0.005), and more parathyroid glands removed (OR 1.45, p = 0.03), while higher preoperative calcium was associated with lower odds of hypocalcemia (OR 0.51, p = 0.02). Late hypocalcemia was independently associated with RYGB (OR 2.38, p = 0.01) and GJ (OR 3.1, p = 0.01). The highest rates of early (81%) and late (71%) hypocalcemia were among those with prior nonbariatric GJ who underwent total thyroidectomy. Early hypocalcemia was associated with prolonged length of stay and 30-day readmission.
conclusionsPatients with prior GJ or RYGB frequently experience hypocalcemia following cervical procedures, informing preoperative counseling and perioperative management. Preoperative calcium optimization is a potential mitigative strategy warranting further study.
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