Revisional operations for marginal ulcer after Roux-en-Y gastric bypass

Surgery for Obesity and Related Diseases : Official Journal of the American Society for Bariatric Surgery
Rohit A PatelAlok Gandhi

Abstract

Marginal ulcer is a potentially serious complication of Roux-en-Y gastric bypass (RYGB). This study reviewed 1 surgeon's experience with 39 revisional operations for intractable marginal ulcer after primary RYGB. A total of 2282 consecutive patients underwent RYGB by 1 surgeon from 1984 to 2006, of which 1621 were open and 661 laparoscopic. The stomach was transected in laparoscopic RYGB and was left undivided in the open group. All revisions included ulcer excision, revision of the gastrojejunostomy with gastric transection as needed. Six patients underwent vagotomy. Of the 2282 patients, 122 (5.3%) developed marginal ulcers (88 and 34 from the open and laparoscopic group, respectively). Of these 122 patients, 39 (32%) underwent revision for intractability (35 open and 4 laparoscopic). Of these 39 patients, 28 (71.7%) had gastrogastric fistulas. Risk factors for ulcer (medication, smoking) were present in 26 patients (66.6%). The primary indications of intractability included abdominal pain (66.6%), gastrointestinal bleeding (20.5%), stomal obstruction (10.2%), and perforation (2.5%). Early postoperative complications included 2 leaks (5.1%) and 2 wound infections (5.1%). Three smokers (7.7%) developed recurrent ulcers postope...Continue Reading

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Citations

Nov 5, 2013·Surgery for Obesity and Related Diseases : Official Journal of the American Society for Bariatric Surgery·Hira AftabTom Mala
Apr 30, 2014·Surgery for Obesity and Related Diseases : Official Journal of the American Society for Bariatric Surgery·Stacy A BrethauerJohn M Morton
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Feb 18, 2016·Obesity Surgery·Hinali ZaveriSamuel Cottam
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Jan 28, 2014·Surgery for Obesity and Related Diseases : Official Journal of the American Society for Bariatric Surgery·Rena C MoonMuhammad A Jawad
Sep 4, 2012·The Journal of Surgical Research·Hina Y Bhutta, Stanley W Ashley
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Aug 26, 2011·Surgery for Obesity and Related Diseases : Official Journal of the American Society for Bariatric Surgery·Emanuele Lo MenzoMark Kligman
Dec 22, 2015·Surgery for Obesity and Related Diseases : Official Journal of the American Society for Bariatric Surgery·T Javier Birriel, Maher El Chaar
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