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Obesity Surgery
Published in: Obesity Surgery 5/2015

01-05-2015 | Original Contributions

Symptomatic Marginal Ulcer Disease After Roux-en-Y Gastric Bypass: Incidence, Risk Factors and Management

Authors: Usha K. Coblijn, Sjoerd M. Lagarde, Steve M. M. de Castro, Sjoerd D. Kuiken, Bart A. van Wagensveld

Published in: Obesity Surgery | Issue 5/2015

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Abstract

Background

One of the long-term complications of laparoscopic Roux-and-Y gastric bypass (LRYGB) is the development of marginal ulcers (MU). The aim of the present study is to assess the incidence, risk factors, symptomatology and management of patients with symptomatic MU after LRYGB surgery.

Methods

A consecutive series of patients who underwent a LRYGB from 2006 until 2011 were evaluated in this study. Signs of abdominal pain, pyrosis, nausea or other symptoms of ulcer disease were analysed. Acute symptoms of (perforated) MU such as severe abdominal pain, vomiting, melena and haematemesis were also collected. Patient baseline characteristics, medication and intoxications were recorded. Statistical analysis was performed to identify risk factors associated with MU.

Results

A total of 350 patients underwent a LRYGB. Minimal follow-up was 24 months. Twenty-three patients (6.6 %) developed a symptomatic MU of which four (1.1 %) presented with perforation. Smoking, the use of corticosteroids and non-steroidal anti-inflammatory drugs (NSAIDs) was significantly associated with the development of MU. Five out of 23 patients (22 %) underwent surgery. All other patients could be treated conservatively.

Conclusions

Marginal ulcers occurred in 6.6 % of the patients after a LRYGB. Smoking, the use of corticosteroids and the use of NSAIDs were associated with an increased risk of MU. Most patients were managed conservatively.
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Metadata
Title
Symptomatic Marginal Ulcer Disease After Roux-en-Y Gastric Bypass: Incidence, Risk Factors and Management
Authors
Usha K. Coblijn
Sjoerd M. Lagarde
Steve M. M. de Castro
Sjoerd D. Kuiken
Bart A. van Wagensveld
Publication date
01-05-2015
Publisher
Springer US
Published in
Obesity Surgery / Issue 5/2015
Print ISSN: 0960-8923
Electronic ISSN: 1708-0428
DOI
https://doi.org/10.1007/s11695-014-1482-9

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