Marginal Ulcers Following One-Anastomosis Gastric Bypass: a Systematic Review and Meta-analysis

Lee, Shiela; Supparamaniam, Shreyas; Varghese, Chris; Mahawar, Kamal

doi:10.1007/s11695-023-06762-5

Cited by 5 publications

(4 citation statements)

References 51 publications

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“…They reported four cases of MU representing 10.3%. In a recent systematic review and meta-analysis, the reported prevalence was 2.6% [ 7 ]. In an international survey of MBS surgeons that performed a combined total of 27,672 OAGB, the reported MU rate was 2.2% [ 6 ].…”

Section: Discussionmentioning

confidence: 99%

“…One of the long-term complications that could be encountered after OAGB is a marginal ulcer (MU) at the gastro–jejunal anastomotic site. MU is reported to occur in 2–3% of patients after OAGB and can present months to years after OAGB [ 6 , 7 , 8 ]. It is usually associated with heavy smoking and can also be associated with lack of adherence to postoperative prophylactic proton pump inhibitors (PPI), use of non-steroidal anti-inflammatory drugs (NSAIDS), Helicobacter pylori (HP) infection, and consumption of corticosteroids [ 9 ].…”

Section: Introductionmentioning

confidence: 99%

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Marginal Ulcer Perforation after One Anastomosis Gastric Bypass: Surgical Treatment and Two-Year Outcomes

Abu-Abeid,

Litmanovich,

Yuval

et al. 2024

JCM

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Background: Marginal ulcer (MU) perforation is a chronic complication after One-anastomosis Gastric Bypass (OAGB). This study’s purpose was to analyze patients undergoing OAGB revision due to MU perforation and describe the two-year outcomes. Methods: A retrospective analysis of a database in a single-tertiary hospital. All patients undergoing surgical revision due to MU perforation were included. Results: During the study period, 22 patients underwent OAGB revision due to MU perforation. The rate of MU perforation was 0.98%. The median age was 48 years and there were 13 men (59%). The median time from OAGB to MU perforation was 19 months with a median total weight loss of 31.5%. Nine patients (41%) were smokers. Omental patch (±primary closure) was performed in 19 patients (86%) and three patients (14%) underwent conversion to Roux-en-Y gastric bypass (RYGB). At a median follow-up of 48 months, three patients (14%) had recurrent MU diagnosis, of which one had a recurrent MU perforation. Four patients (18%) underwent conversion to RYGB during follow-up. Conclusions: MU perforation is a chronic complication after OAGB. In this cohort, most patients were men and likely to be smokers. Omental patch was effective in most cases. Recurrent MU rates at two years follow-up were acceptable.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Marginal Ulcer Perforation after One Anastomosis Gastric Bypass: Surgical Treatment and Two-Year Outcomes

Abu-Abeid,

Litmanovich,

Yuval

et al. 2024

JCM

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“…OAGB has been identified as a reliable and feasible revisional procedure after SG. It offers promising outcomes, including a simple technique, good long-term weight loss and improved metabolic parameters, but bile reflux and anastomotic ulcer represent potential procedure-related issues, ranging from 7.8 to 55.5% [ 15 – 17 ] and 0.47 to 7.35%, respectively [ 18 ].…”

Section: Introductionmentioning

confidence: 99%

One-Anastomosis Gastric Bypass (OABG) vs. Single Anastomosis Duodeno-Ileal Bypass (SADI) as revisional procedure following Sleeve Gastrectomy: results of a multicenter study

Gallucci,

Marincola,

Pennestrì

et al. 2024

Langenbecks Arch Surg

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Purpose Sleeve Gastrectomy (SG) is the most performed bariatric surgery, but a considerable number of patients may require revisional procedures for suboptimal clinical response/recurrence of weight (SCR/RoW). Conversion options include One-Anastomosis Gastric Bypass (OAGB) and Single Anastomosis Duodeno-Ileal Bypass (SADI). The study aims to compare SADI vs. OAGB as revisional procedures in terms of early and mid-term complications, operative time, postoperative hospital stay and clinical outcomes. Methods All patients who underwent OAGB or SADI as revisional procedures following SG for SCR/RoW at three high-volume bariatric centers between January 2014 and April 2021 were included. Propensity score matching (PSM) analysis was performed. Demographic, operative, and postoperative outcomes of the two groups were compared. Results One hundred and sixty-eight patients were identified. After PSM, the two groups included 42 OAGB and 42 SADI patients. Early (≤ 30 days) postoperative complications rate did not differ significantly between OAGB and SADI groups (3 bleedings vs. 0, p = 0.241). Mid-term (within 2 years) complications rate was significantly higher in the OAGB group (21.4% vs. 2.4%, p = 0.007), mainly anastomotic complications and reflux disease (12% of OAGBs). Seven OAGB patients required conversion to another procedure (Roux-en-Y Gastric Bypass—RYGB) vs. none among the SADI patients (p = 0.006). Conclusions SADI and OAGB are both effective as revisional procedures for SCR/RoW after SG. OAGB is associated with a significantly higher rate of mid-term complications and a not negligible rate of conversion (RYGB). Larger studies are necessary to draw definitive conclusions.

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“…End-stage renal disease (ESRD) is a global public health problem, with increasing prevalence rates worldwide in conjunction with population aging and increasing incidences of diabetes mellitus (DM), hypertension, and chronic kidney disease (1)(2)(3)(4). The average number of new ESRD diagnoses worldwide is 144 individuals per million populations (5). However, the incidence of ESRD varies significantly across countries.…”

Section: Introductionmentioning

confidence: 99%

Impact of the geriatric nutritional risk index on long-term outcomes in patients undergoing hemodialysis: a meta-analysis of observational studies

Hung,

Kao,

Hsu

et al. 2024

Front. Nutr.

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BackgroundThis meta-analysis aimed to synthesize current evidence on the association between the Geriatric Nutritional Risk Index (GNRI) and long-term outcomes in patients undergoing hemodialysis.MethodsElectronic databases were systematically searched for relevant studies that investigated the association between GNRI and long-term outcomes in hemodialysis patients until November 2023. The primary outcome was the association between the GNRI (i.e., low versus high) and overall mortality risk, while the secondary outcome was the relationship between the GNRI and cardiovascular mortality risk.ResultsThirty cohort studies involving 55,864 patients were included. A low GNRI was found to be significantly associated with increased overall mortality (hazard ratio [HR]: 2.42, 95% confidence interval [CIs]: 2.10–2.79, p < 0.00001, I2 = 65%). Each unit increase in GNRI corresponded to a 5% reduction in mortality risk (HR: 0.95, 95% CI: 0.93–0.96, p < 0.00001, I2 = 79%). The association remained consistent across Asian (HR = 2.45, 95% CI: 2.08–2.88, p < 0.00001, I2 = 70%) and non-Asian subgroups (HR = 2.3, 95% CI: 1.72–3.06, p < 0.00001, I2 = 23%). Meta-regression analysis of patient age (coefficient: −0.002; p = 0.896), male proportion (coefficient: 0.002; p = 0.875), percentage of diabetes mellitus (coefficient: −0.003; p = 0.605), and follow-up duration (coefficient: −0.003; p = 0.431) revealed that these moderator variables did not significantly influence the association between GNRI and overall mortality risk. Cardiovascular mortality risk also increased with low GNRI (HR, 1.93; 95%CI: 1.51–2.45, p < 0.00001; I2 = 2%). Similarly, an inverse association was observed between the GNRI values and cardiovascular mortality risk (HR, 0.94; 95% CI: 0.91–0.97; p < 0.0001; I2 = 65%) (per unit increase).ConclusionThe GNRI is a simple nutritional screening tool that can be used to effectively stratify patients undergoing hemodialysis globally. Further studies are warranted to determine whether nutrition optimization based on the GNRI improves long-term outcomes.Systematic review registrationhttps://www.crd.york.ac.uk/prospero/, CRD42023483729.

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Marginal Ulcers Following One-Anastomosis Gastric Bypass: a Systematic Review and Meta-analysis

Cited by 5 publications

References 51 publications

Marginal Ulcer Perforation after One Anastomosis Gastric Bypass: Surgical Treatment and Two-Year Outcomes

Marginal Ulcer Perforation after One Anastomosis Gastric Bypass: Surgical Treatment and Two-Year Outcomes

One-Anastomosis Gastric Bypass (OABG) vs. Single Anastomosis Duodeno-Ileal Bypass (SADI) as revisional procedure following Sleeve Gastrectomy: results of a multicenter study

Impact of the geriatric nutritional risk index on long-term outcomes in patients undergoing hemodialysis: a meta-analysis of observational studies

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