Wernicke Encephalopathy after Bariatric Surgery: Single-Center Experience

Abstract

Background:

Wernicke encephalopathy (WE) is increasingly recognized as a complication following bariatric surgery.

Methods:

We retrospectively evaluated patients who developed WE after bariatric surgery. Surgery was based on the National Institutes of Health criteria, and it was performed laparoscopically. Patients resumed oral intake following a successful leak test. Follow-up examinations were done periodically at 1, 3, 6, 9, and 12 months. Continuous variables are reported as medians with ranges, while discrete variables are presented as frequencies.

Results:

Among 2,267 patients who underwent bariatric surgery, 1,777 (78%) had sleeve gastrectomy, and 490 (22%) had one anastomosis gastric bypass. WE was diagnosed in nine patients (0.4%). The median time to readmission for WE was 2 months (1.8–67). Symptoms included vomiting, nausea, anorexia, ataxia, ophthalmoplegia, diplopia, confusion, and amnesia. All patients received intravenous thiamine. One patient developed Korsakoff’s syndrome and later succumbed to sepsis related to large pressure ulcers. Two patients achieved complete recovery, while six exhibited minor residual memory impairments, with two of them also experiencing mild gait disturbances.

Conclusions:

WE is a serious complication that can occur after bariatric surgery, associated with severe vomiting and rapid weight loss, and can be prevented through thiamine supplementation.