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Endoscopy after Roux-en-Y gastric bypass: a community hospital experience.
Obes Surg. 2005 Mar; 15(3):342-5.OS

Abstract

BACKGROUND

Roux-en-Y gastric bypass (RYGBP) is a common surgical intervention for morbid obesity. Postoperative GI symptoms are common. This study reports the endoscopic findings in symptomatic patients.

METHODS

Patients who developed GI symptoms after RYGBP at a single community hospital were referred for endoscopic evaluation. Standard endoscopic procedures using standard endoscopic equipment were used.

RESULTS

From April 2002 to April 2004, 23 out of 200 patients underwent 35 endoscopic procedures. All patients complained of some degree of epigastric pain, nausea and vomiting regardless of endoscopic findings. The most common endoscopic finding was ulcer disease (12 patients - 52%). Other findings included normal postoperative anatomy (7 patients - 30%), anastomotic stricture (1 patient - 4.3%), obstructed biliopancreatic limb (1 patient - 4.3%), acute gastric pouch bleed (1 patient - 4.3%), anastomotic rupture/dehiscence (1 patient - 4.3%). H. pylori was not detected in any patient.

CONCLUSIONS

In patients who have had RYGBP, symptoms were a poor predictor of endoscopic pathology. Ulcer disease was the most common endoscopic finding. These ulcers were not associated with H. pylori. All ulcers responded well to oral proton pump inhibitors (PPI) and sucralfate therapy. The community gastroenterologist should be acquainted with the typical post-surgical anatomy and possible endoscopic intervention for RYGBP patients.

Authors+Show Affiliations

Department of Internal Medicine, Section of Gastroenterology, White Plains Hospital Center, White Plains, NY, USA. benmarano@optonline.net

Pub Type(s)

Journal Article

Language

eng

PubMed ID

15826466

Citation

Marano, Benjamin J.. "Endoscopy After Roux-en-Y Gastric Bypass: a Community Hospital Experience." Obesity Surgery, vol. 15, no. 3, 2005, pp. 342-5.
Marano BJ. Endoscopy after Roux-en-Y gastric bypass: a community hospital experience. Obes Surg. 2005;15(3):342-5.
Marano, B. J. (2005). Endoscopy after Roux-en-Y gastric bypass: a community hospital experience. Obesity Surgery, 15(3), 342-5.
Marano BJ. Endoscopy After Roux-en-Y Gastric Bypass: a Community Hospital Experience. Obes Surg. 2005;15(3):342-5. PubMed PMID: 15826466.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Endoscopy after Roux-en-Y gastric bypass: a community hospital experience. A1 - Marano,Benjamin J,Jr PY - 2005/4/14/pubmed PY - 2005/7/15/medline PY - 2005/4/14/entrez SP - 342 EP - 5 JF - Obesity surgery JO - Obes Surg VL - 15 IS - 3 N2 - BACKGROUND: Roux-en-Y gastric bypass (RYGBP) is a common surgical intervention for morbid obesity. Postoperative GI symptoms are common. This study reports the endoscopic findings in symptomatic patients. METHODS: Patients who developed GI symptoms after RYGBP at a single community hospital were referred for endoscopic evaluation. Standard endoscopic procedures using standard endoscopic equipment were used. RESULTS: From April 2002 to April 2004, 23 out of 200 patients underwent 35 endoscopic procedures. All patients complained of some degree of epigastric pain, nausea and vomiting regardless of endoscopic findings. The most common endoscopic finding was ulcer disease (12 patients - 52%). Other findings included normal postoperative anatomy (7 patients - 30%), anastomotic stricture (1 patient - 4.3%), obstructed biliopancreatic limb (1 patient - 4.3%), acute gastric pouch bleed (1 patient - 4.3%), anastomotic rupture/dehiscence (1 patient - 4.3%). H. pylori was not detected in any patient. CONCLUSIONS: In patients who have had RYGBP, symptoms were a poor predictor of endoscopic pathology. Ulcer disease was the most common endoscopic finding. These ulcers were not associated with H. pylori. All ulcers responded well to oral proton pump inhibitors (PPI) and sucralfate therapy. The community gastroenterologist should be acquainted with the typical post-surgical anatomy and possible endoscopic intervention for RYGBP patients. SN - 0960-8923 UR - https://www.unboundmedicine.com/medline/citation/15826466/Endoscopy_after_Roux_en_Y_gastric_bypass:_a_community_hospital_experience_ L2 - https://dx.doi.org/10.1381/0960892053576767 DB - PRIME DP - Unbound Medicine ER -