Marginal ulcer causing delayed anastomotic perforation following one anastomosis gastric bypass (OAGB)

Aviran, Eyal; Rayman, Shlomi; Yehuda, Amir Ben; Goitein, David

doi:10.1016/j.soard.2020.09.022

Cited by 16 publications

(7 citation statements)

References 28 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…However, notably these studies reported a 0% 30-day mortality, likely representing a more stable presentation. 1,4 The one remaining patient in the Martino et al study was identified in the paper by Aviran et al, 8 which was included in this systematic review. Coblijn et al noted a patient in 2015 who developed a PMU adjacent to a nasojejunal tube 3 weeks after conversion of adjustable gastric banding to RYGB.…”

Section: Resultsmentioning

confidence: 99%

Non-Operative Approach to Contained Perforated Marginal Ulcers: A Systematic Review and Case Series

Pope,

English,

Walden

et al. 2023

The American Surgeon™

View full text Add to dashboard Cite

Background Perforated marginal ulcers (PMUs) are a rare but known complication of bariatric surgery. Management typically involves prompt surgical intervention, but limited data exists on non-operative approaches. This study reviews published data on non-operative management of PMUs and presents a case series of patients who were managed non-operatively. Our hypothesis is that certain patients with signs of perforation can be successfully managed non-operatively with close observation. Methods We completed a systematic review searching PubMed, Embase, Web of Science, Cochrane, and clinicaltrials.gov. Ultimately 3 studies described the presentation and non-operative management of 5 patients. Additionally, we prospectively collected data from our institution on all patients who presented between Dec. 2022 and Dec. 2023 with PMUs confirmed on imaging and managed non-operatively. Results In our literature review, three patients had Roux-en-Y gastric bypass (RYGB), while two had one anastomosis gastric bypass. One patient required surgery two days after admission. Another underwent elective conversion surgery weeks later for a non-healing ulcer. Two received endoscopic interventions. One patient recovered with nil-per-os (NPO) status, and intravenous proton pump inhibitor (PPI) treatment. The patients in our case series presented with normal vital signs, an average of 30 months after RYGB, and with CT scan signs of perforation. None of these patients required surgical or endoscopic intervention. Conclusion In conclusion, while perforated marginal ulcers have traditionally been considered a surgical emergency, some patients can be successfully treated with non-operative management. More research is needed to identify the clinical presentation features, comorbidities, and imaging findings of this group.

show abstract

Section: Resultsmentioning

confidence: 99%

Non-Operative Approach to Contained Perforated Marginal Ulcers: A Systematic Review and Case Series

Pope,

English,

Walden

et al. 2023

The American Surgeon™

View full text Add to dashboard Cite

show abstract

“…However, the prevalence and significance of this phenomenon are still subjects of concern, as findings vary based on surgical techniques employed [ 33 , 34 ]. Even though we did not thoroughly assess bile reflux using esophagogastroduodenoscopy and 24-h pH-metry, at least theoretically, this complication could be related to the effect of the aforementioned OAGB design [ 31 , 35 – 37 ]. Additionally, retained gastric antrum syndrome might also contribute to the high incidence of anastomotic ulcers [ 38 ].…”

Section: Discussionmentioning

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

View full text Add to dashboard Cite

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.

show abstract

“…As a result of marginal ulcer after MGBP, perforation can be seen with a frequency of 8.2% and bleeding with a frequency of 9.5% (22,23). A series of 7 cases with delayed anastomotic perforation caused by marginal ulcer after MGBP has been published (3). In a cohort study, 1-year outcomes of SG, MGBP and SG-TB operations were compared.…”

Section: Discussionmentioning

confidence: 99%

Marginal ulcer after mini gastric by-pass and sleeve gastrectomy with transit bipartition

Al¹

2022

J Exp Clin Med

View full text Add to dashboard Cite

The aim of this study to present the incidence of marginal ulcer among patients who underwent laparoscopic mini gastric by-pass (MGBP) or laparoscopic sleeve gastrectomy with transit bipartition (SG-TB), and to determine demographic, clinical and surgical risk factors associated with marginal ulcer development. This case-control study was designed as a retrospective analysis of an SG-TB and MGBP surgical series. The marginal ulcer group consisted of 8 patients who developed marginal ulcers during their follow-up. The control group was formed with a randomly selected sample of 18 people matching according to age, sex and operation type among the remaining 626 patients. The median age of all patients included in the study was 51 (27-62) years. 75.0% of the marginal ulcer group and 66.7% of the control group were males (p = 1.000). Marginal ulcer developed in 1.26% of all patients who underwent bariatric-metabolic surgery, in 6.45% of patients who underwent MGBP, and in 0.99% of patients who underwent SG-TB. It was observed that the ulcers of all cases recovered completely. No perforation was observed in any patient, no surgical intervention was required, and no marginal ulcer-related mortality was observed. There was no significant difference between the marginal ulcer group and the control group in terms of surgical, clinical and demographic features. Considering our practices and results, it was thought that post-operative PPI treatment for at least 6 months had a preventive effect on marginal ulcer development, and PPI treatment used after marginal ulcer development had an important role in healing.

show abstract

Marginal ulcer causing delayed anastomotic perforation following one anastomosis gastric bypass (OAGB)

Cited by 16 publications

References 28 publications

Non-Operative Approach to Contained Perforated Marginal Ulcers: A Systematic Review and Case Series

Non-Operative Approach to Contained Perforated Marginal Ulcers: A Systematic Review and Case Series

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

Marginal ulcer after mini gastric by-pass and sleeve gastrectomy with transit bipartition

Contact Info

Product

Resources

About