In accredited centers, bariatric surgery is performed with very low mortality, morbidity,
and readmission rates [
1
,
2
,
3
]. However, a small number of bariatric patients develop postoperative complications
such as marginal ulcers. Previous reports cite the incidence of marginal ulcer with
significant variability, from .6% to 16% [
[4]
]. The etiology of marginal ulcers after a laparoscopic Roux-en-Y gastric bypass is
a matter of debate. Many factors are believed to contribute to the development of
marginal ulcers, such as smoking, ischemia, foreign body reaction, gastrogastric fistulas,
large gastric pouches, and tension at the anastomosis [
5
,
6
,
7
,
8
,
9
].Keywords
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References
- Improving outcome of bariatric surgery: best practices in an accredited surgical center.Obes Surg. 2014; 24: 1057-1063
- Perioperative safety in the longitudinal assessment of bariatric surgery.N Engl J Med. 2009; 361: 445-454
- A prospective randomized trial of laparoscopic gastric bypass versus laparoscopic adjustable gastric banding for the treatment of morbid obesity: outcomes, quality of life, and costs.Ann Surg. 2009; 250: 631-641
- Revisional operations for marginal ulcer after Roux-en-Y gastric bypass.Surg Obes Relat Dis. 2009; 5: 317-322
- Laparoscopic revision of gastrojejunostomy and vagotomy for intractable marginal ulcer after revised gastric bypass.Surg Obes Relat Dis. 2011; 7: 656-658
- Marginal ulceration after Roux-en-Y gastric bypass surgery: characteristics, risk factors, treatment, and outcomes.Endoscopy. 2011; 43: 950-954
- Marginal ulceration after laparoscopic gastric bypass: an analysis of predisposing factors in 260 patients.Surg Endosc. 2007; 21: 1090-1094
- Management and treatment outcomes of marginal ulcers after Roux-en-Y gastric bypass at a single high volume bariatric center.Surg Obes Relat Dis. 2014; 10: 229-234
Chau E., Heekoung Y., Ren-Fielding C., et al. Surgical management and outcomes of patients with marginal ulcer after Roux-en-Y gastric bypass. Surg Obes Relat Dis. Epub 2014 Dec 19.
- Laparoscopic revision of gastrojejunostomy revision with truncal vagotomy for persistent marginal ulcer after Roux-en-Y gastric bypass.Surg Obes Relat Dis. 2010; 6: 561-562
- Surgical technique affects the incidence of marginal ulceration after Roux-en-Y gastric bypass.Surg Sci. 2013; 4: 1-7
- Effectiveness of thoracoscopic truncal vagotomy in the treatment of marginal ulcers after laparoscopic Roux-en-Y gastric bypass.Am Surg. 2012; 78: 663-668
Article info
Publication history
Published online: October 16, 2015
Accepted:
October 13,
2015
Received:
September 25,
2015
Footnotes
☆Accepted for video presentation at Obesity Week 2015, Los Angeles, CA.
Identification
Copyright
© 2016 American Society for Bariatric Surgery. Published by Elsevier Inc. All rights reserved.
