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Ulcer disease after gastric bypass surgery.
Surg Obes Relat Dis. 2006 Jul-Aug; 2(4):455-9.SO

Abstract

BACKGROUND

The mechanism of marginal ulceration after laparoscopic gastric bypass surgery is poorly understood. We reviewed the incidence, presentation, and outcome of ulcer disease in consecutive patients undergoing laparoscopic gastric bypass surgery.

METHODS

The outcomes of 201 consecutive laparoscopic gastric bypass surgery procedures were prospectively analyzed for complications. All procedures were performed using a linear stapled anastomosis and absorbable suture.

RESULTS

The incidence of marginal ulcer disease was 3.5% (7 patients). One patient, the only smoker, presented with an acute perforation 4 months postoperatively. Three other patients presented with bleeding-all required transfusion. The remaining 3 patients presented with severe pain. At endoscopy, all patients had ulcerations associated with the Roux limb mucosa and were all successfully treated using proton pump inhibitors and sucralfate therapy. Symptoms of marginal ulceration occurred an average of 7.4 months (range 3-14) after surgery. The average follow-up was 19.8 months. No preoperative factors were predictors of ulcer disease, including body mass index, age, gender, or co-morbidities.

CONCLUSION

Marginal ulcers using the linear-stapled technique occurred in 3.5% of patients. Three distinct clinical presentations occurred: bleeding, pain, or perforation. No preoperative risk factors were identified that predicted for this complication. Medical management is an effective treatment.

Authors+Show Affiliations

Albert Einstein Healthcare Network, Philadelphia, PA USA. dallalr@einstein.eduNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

16925380

Citation

Dallal, Ramsey M., and Linda A. Bailey. "Ulcer Disease After Gastric Bypass Surgery." Surgery for Obesity and Related Diseases : Official Journal of the American Society for Bariatric Surgery, vol. 2, no. 4, 2006, pp. 455-9.
Dallal RM, Bailey LA. Ulcer disease after gastric bypass surgery. Surg Obes Relat Dis. 2006;2(4):455-9.
Dallal, R. M., & Bailey, L. A. (2006). Ulcer disease after gastric bypass surgery. Surgery for Obesity and Related Diseases : Official Journal of the American Society for Bariatric Surgery, 2(4), 455-9.
Dallal RM, Bailey LA. Ulcer Disease After Gastric Bypass Surgery. Surg Obes Relat Dis. 2006 Jul-Aug;2(4):455-9. PubMed PMID: 16925380.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Ulcer disease after gastric bypass surgery. AU - Dallal,Ramsey M, AU - Bailey,Linda A, PY - 2006/02/03/received PY - 2006/03/04/revised PY - 2006/03/08/accepted PY - 2006/8/24/pubmed PY - 2006/9/27/medline PY - 2006/8/24/entrez SP - 455 EP - 9 JF - Surgery for obesity and related diseases : official journal of the American Society for Bariatric Surgery JO - Surg Obes Relat Dis VL - 2 IS - 4 N2 - BACKGROUND: The mechanism of marginal ulceration after laparoscopic gastric bypass surgery is poorly understood. We reviewed the incidence, presentation, and outcome of ulcer disease in consecutive patients undergoing laparoscopic gastric bypass surgery. METHODS: The outcomes of 201 consecutive laparoscopic gastric bypass surgery procedures were prospectively analyzed for complications. All procedures were performed using a linear stapled anastomosis and absorbable suture. RESULTS: The incidence of marginal ulcer disease was 3.5% (7 patients). One patient, the only smoker, presented with an acute perforation 4 months postoperatively. Three other patients presented with bleeding-all required transfusion. The remaining 3 patients presented with severe pain. At endoscopy, all patients had ulcerations associated with the Roux limb mucosa and were all successfully treated using proton pump inhibitors and sucralfate therapy. Symptoms of marginal ulceration occurred an average of 7.4 months (range 3-14) after surgery. The average follow-up was 19.8 months. No preoperative factors were predictors of ulcer disease, including body mass index, age, gender, or co-morbidities. CONCLUSION: Marginal ulcers using the linear-stapled technique occurred in 3.5% of patients. Three distinct clinical presentations occurred: bleeding, pain, or perforation. No preoperative risk factors were identified that predicted for this complication. Medical management is an effective treatment. SN - 1550-7289 UR - https://www.unboundmedicine.com/medline/citation/16925380/Ulcer_disease_after_gastric_bypass_surgery_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1550-7289(06)00244-9 DB - PRIME DP - Unbound Medicine ER -