Marginal ulceration after laparoscopic gastric bypass: an analysis of predisposing factors in 260 patients

Rasmussen, Jason J.; Fuller, Wayne A.; Ali, Mohamed R.

doi:10.1007/s00464-007-9285-x

Cited by 247 publications

(143 citation statements)

References 37 publications

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“…A comparison of patients with and without marginal ulcers within 10 months after surgery demonstrated that marginal ulceration was more common among patients who tested positive for H. pylori even when adequately treated. 12 Other studies looking at complications following gastric bypass surgery in patients with H. pylori infection also suggest some relation between postoperative complications and the presence of H. pylori. 9,13 Although this may imply a benefit to preoperative screening and treatment, there are also conflicting studies.…”

Section: Discussionmentioning

confidence: 99%

“…9,12 Knowing the potential changes that this may cause, it is possible that histological consequences from H. pylori may be related to certain complications after bariatric surgery. A comparison of patients with and without marginal ulcers within 10 months after surgery demonstrated that marginal ulceration was more common among patients who tested positive for H. pylori even when adequately treated.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Is Helicobacter Pylori Associated with an Increased Complication Rate after Sleeve Gastrectomy?

Gonzalez-Heredia

Tirado

Patel

et al. 2015

Bariatric Surgical Practice and Patient Care

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Is Helicobacter Pylori Associated with an Increased Complication Rate after Sleeve Gastrectomy?

Gonzalez-Heredia

Tirado

Patel

et al. 2015

Bariatric Surgical Practice and Patient Care

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“…This induces exacerbation of the ulcer, even if the organism has already been treated. 63,68,69 All these factors may have influenced the increased prescription of antisecretory drugs observed in this study.…”

Section: Gastric Antisecretory Agentsmentioning

confidence: 90%

“…Development of stomach ulcers is one of the biggest and most common complications associated with the gastric bypass technique, 63,64 and it is reported in 1% to 20% of the patients after surgery. 65,66 Stomach ulcers may develop over the short term, possibly associated with technical problems at the intervention site.…”

Section: Gastric Antisecretory Agentsmentioning

confidence: 99%

Medication and nutritional supplement use before and after bariatric surgery

Backes

Lopes²,

Tetelbom

et al. 2016

Sao Paulo Med. J.

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CONTEXT AND OBJECTIVE: Bariatric surgery has been an effective alternative treatment for morbid obesity and has resulted in decreased mortality, better control over comorbidities and reduced use of drugs. The objective of this study was to analyze the impact of bariatric surgery on medication drug and nutritional supplement use. DESIGN AND SETTING: Longitudinal study of before-and-after type, on 69 morbidly obese patients in a public hospital in Porto Alegre. METHODS: Through interviews, the presence of comorbidities and use of drugs with and without prescription were evaluated. RESULTS: Among the 69 patients interviewed, 85.5% had comorbidities in the preoperative period, with an average of 2.3 (± 1.5) per patient. The main comorbidities reported were hypertension, diabetes and dyslipidemia. 84.1% of the patients were using prescribed drugs in the preoperative period. The mean drug use per patient was 4.8, which decreased to 4.4 after the procedure. The surgery enabled significant reduction in use of most antidiabetic (84%), antilipemic (77%) and antihypertensive drugs (49.5%). On the other hand, there was a significant increase in use of multivitamins and drugs for disorders of the gastrointestinal tract. The dosages of most of the drugs that continued to be prescribed after surgery were decreased, but not significantly. CONCLUSION: After bariatric surgery, there were increases in the use of vitamins, gastric antisecretory drugs and antianemic drugs. Nevertheless, there was an overall reduction in drug use during this period, caused by suspension of drugs or dose reduction. RESUMO CONTEXTO E OBJETIVO:A cirurgia bariátrica tem sido uma alternativa efetiva de tratamento para a obesidade mórbida, resultando na diminuição da mortalidade, melhor controle das comorbidades e redução no uso de medicamentos. O objetivo deste estudo foi analisar o impacto da cirurgia bariátrica sobre a utilização de medicamentos e suplementos nutricionais. TIPO DE ESTUDO E LOCAL: Estudo longitudinal do tipo antes e depois com 69 pacientes obesos mórbi-dos em um hospital público de Porto Alegre. MÉTODOS: Nas entrevistas, foram avaliados a presença de comorbidades e o uso de medicamentos com e sem prescrição médica. RESULTADOS: De 69 pacientes entrevistados, 85,5% apresentaram comorbidades no período pré-cirúrgi-co, média de 2,3 (± 1,5) por paciente. As principais comorbidades relatadas foram hipertensão, diabetes e dislipidemias. 84,1% dos pacientes estavam em uso de medicamentos sob prescrição médica, no período pré-cirúrgico. A média de uso de medicamentos por paciente foi de 4,8, reduzindo para 4,4 após o procedimento. A cirurgia proporcionou diminuição significativa do uso da maioria dos antidiabéticos (84%), antilipêmicos (77%) e anti-hipertensivos (49,5%). Por outro lado, observou-se aumento significativo na utilização de multivitamínicos e medicamentos para desordens do trato gastrointestinal. A maior parte dos medicamentos que continuaram sendo prescritos após a cirurgia teve sua dose reduzida, no entanto, esta redução nã...

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“…Marginal entero-enteric ulcers are a well-documented complication of Roux-en-Y gastric bypass, with an incidence between 0.6% and 16% [4,5]. The majority of the published reports regarding post-gastric bypass marginal ulceration are retrospective; therefore, only symptomatic patients have been investigated, and the data we found from such studies are limited.…”

Section: Discussionmentioning

confidence: 99%

Delayed Perforated Ulceration at the Entero-Enteric Anastomosis after Rouex En-Y Gastric Bypass

Al-Subaie¹

2017

AOWMC

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Marginal ulceration after gastric bypass is a proven complication with an incidence between 1% and 16%, and the exact mechanism of ulceration is not well established. Helicobacter pylori, smoking, Non-Steroidal Anti-inflammatory Drug (NSAID) use, and noncompliance with Proton Pump Inhibitor (PPI) postoperatively may contribute to marginal ulceration, but evidence is still lacking in the literature. This report reviews the case of a 25-year-old woman who underwent a combined Roux-en-Y gastric bypass after a Laparoscopic Sleeve Gastrostomy (LSG) for morbid obesity and subsequently developed a delayed perforated ulceration at the entero-enteric anastomosis post Rouex en-Y gastric bypass. In the literature, there are few examples of cases similar to our patient's case with explanations of the predisposing factors, presentation, and management of the ulceration at the anastomosis post Rouex en-Y gastric bypass. Keywords:

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Marginal ulceration after laparoscopic gastric bypass: an analysis of predisposing factors in 260 patients

Abstract: Helicobacter pylori may potentiate marginal ulcer formation. The authors hypothesize that H. pylori damages the mucosal barrier in a way that persists postoperatively, which may precipitate marginal ulceration even when the organism has been medically eradicated.

Cited by 247 publications

References 37 publications

Is Helicobacter Pylori Associated with an Increased Complication Rate after Sleeve Gastrectomy?

Is Helicobacter Pylori Associated with an Increased Complication Rate after Sleeve Gastrectomy?

Medication and nutritional supplement use before and after bariatric surgery

Delayed Perforated Ulceration at the Entero-Enteric Anastomosis after Rouex En-Y Gastric Bypass

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