Patients are admitted to hospital the day before surgery at 9 a.m., unless earlier observation is required. After surgery they remain in postoperative care or in intensive care for one day. They are discharged from the department after 5 to 7 days.

Discharge medication consists of: Motilium 15 minutes before meals, Loperamide, Alvityl plus one a day and Cacit 1000 one a day, Omeprazole 20 one a day, Fraxiparine 0.8 for 10 to 20 days.

Further follow-up is as follows: laboratory control once a month for the first 3 months, subsequent controls after 2 months and every 3 months afterwards for the first 2 years.

Later too, we recommend laboratory controls 2 to 3 times annually. These controls can be performed by the general practitioner or by Dr. Lemmens, but we like to be kept informed about the evolution, in particular in the event of problems.

Attention should be paid to the following elements:
Cytology with Fe, ferritin, Vitamin B12 and folic acid for early detection of iron deficiency or megaloblastic anaemia; total protein with albumin, as well as a few hepatic function tests; electrolytes, calcium, phosphorus and magnesium; vitamins: 25 OH vitamin D, vitamin A and parathormone.
Vitamin B1 dosage is performed only in the event of severely restricted food intake.

How to solve problems?
- iron deficiency anaemia: high doses of Fe (Ferrograd 500, Ferricure or Losferron 2 or more per day).
- megaloblastic anaemia: 1.000 E. vit.B12 I.M. 1 per month (Vit. B 12 1000)
- hypocalcaemia: 1 g Ca of more per day (Cacit 1000 is best)
- hypovitaminosis D: this may be responsible for osteomalacia! If levels drop below normal values, D-cure can be administered orally; 2 or more drinkable ampoules per week.

Generally, treatment for a few months is sufficient.

Parenteral treatment is rarely necessary, but should be performed under supervision.

- Hepatic function is frequently impaired in the first postoperative months, but usually normalizes afterwards. Occasionally fluctuations in hepatic function tests are observed later, but are not usually of clinical significance. In the case of more severe disorders, more extensive investigation is required.