Which Factors Correlate with Marginal Ulcer After Surgery for Obesity?

Duarte-Chavez, Rodrigo; Stoltzfus, Jill; Chaput, Kimberly J.; Maher, El Chaar

doi:10.1007/s11695-020-04960-z

Cited by 23 publications

(12 citation statements)

References 56 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Rodrigo et al performed a univariate analysis of one database, which found aspirin to be a minor risk factor, although a multivariate analysis of the same data found aspirin to be a significant risk factor for marginal ulcer development. 18 Other studies have looked at the role of aspirin in correlation to upper gastrointestinal mucosal injuries, but not specifically at Roux-en-Y postoperative patients. 17,19,20 The largest of the three studies, from Sverden et al, included 20,294 Roux-en-Y bypass patients.…”

Section: Discussionmentioning

confidence: 99%

Aspirin Use as a Risk Factor for Marginal Ulceration in Roux-en-Y Gastric Bypass Patients: A Meta-Analysis of 24,770 Patients

Portela

Sharma

Vahibe

et al. 2022

The American Surgeon™

View full text Add to dashboard Cite

Background Roux-en-Y gastric bypass (RYGB) is a recognized, safe bariatric procedure with minimal complications. Marginal ulceration, however, remains a challenging problem with an incidence of 8-12%. While chronic NSAID use is an established risk factor for ulcer formation, aspirin use itself as a cause for marginal ulceration is still unclear. We aim to compare the rates of marginal ulceration in RYGB with and without aspirin use. Methods PubMed, ScienceDirect, Cochrane, Web of Science, and Google Scholar were searched for articles between 2008 and 2021 by two independent reviewers using the Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA). The risk of bias was assessed using Newcastle-Ottawa Scale. Meta-analysis was conducted using a fixed-effect model. Results From 5324 studies screened, we included 3 studies. Two studies had a low risk of bias, and the other one presented a high risk of bias on the Newcastle-Ottawa Scale. We included 24,770 patients, 1911 with aspirin use and 22,859 without aspirin use. After the meta-analysis, patients who used aspirin had a significantly higher marginal ulceration rate than those who did not (OR = 1.33 [95% CI 1.08 to 1.63], P < .002; I2 = 39%). Conclusions Aspirin use is associated with increased rates of marginal ulceration after RYGB.

show abstract

Section: Discussionmentioning

confidence: 99%

Aspirin Use as a Risk Factor for Marginal Ulceration in Roux-en-Y Gastric Bypass Patients: A Meta-Analysis of 24,770 Patients

Portela

Sharma

Vahibe

et al. 2022

The American Surgeon™

View full text Add to dashboard Cite

show abstract

“…Moreover, there are multiple risk factors related to marginal ulcers, including smoking 27,28,30 , chronic nonsteroidal anti-inflammatory drugs (NSAIDs) use 27,30 , Helicobacter pylori infection 30 , untreated obstructive sleep apnea 30 , and immunosuppression. 27 Therefore, to reduce the risk of marginal ulcer formation, we aim to ensure that all the risk modifications must be achieved before a Roux-en-Y gastric bypass procedure is performed.…”

Section: Discussionmentioning

confidence: 99%

Surgical Outcomes of Bariatric Surgery in Siriraj Hospital for the First 100 Morbidly Obese Patients Treated

et al. 2022

View full text Add to dashboard Cite

Objective: Bariatric surgery is considered the most effective treatment for morbid obesity, and is increasingly performed in Thailand and globally. We aimed to establish the outcomes of bariatric surgery performed at Siriraj Hospital, Bangkok. Materials and Methods: This was a retrospective study of patients who underwent bariatric surgery between January 2012 and June 2016. Results: The records of the first 100 patients who underwent bariatric surgery were reviewed, comprising 58 patients who underwent laparoscopic sleeve gastrectomy (LSG) and 42 patients who underwent laparoscopic Roux-en-Y gastric bypass (LRYGB). The median patient age, preoperative body weight, and BMI were 36 years old, 129 kg, and 46.3 kg/m2. All the procedures were performed by a laparoscopic approach. The median operative times for LSG and LRYGB were 156 [85-435] and 265 [180-435] minutes. The median hospital stay was 3 days [3-14]. The major complication rate was 4%. There was no mortality in the 30-day postoperative period. The mean %excess weight loss (%EWL) of LSG was 56.8 ± 19.8%, 59.9 ± 21.7%, and 55.1 ± 21.3%, at 1, 2, and 3 years after surgery. The mean %EWL of LRYGB was 67 ± 18.3%, 66.2 ± 21.4%, and 63.6 ± 19.9%, at 1, 2, and 3 years after surgery. In the patients with type-II diabetes mellitus, 67% had complete diabetic remission at 1 year. The median FBS dropped from 127 to 99 mg/dL (p < 0.001) and HbA1c from 6.6% to 5.5% (p < 0.001). The remission rates of hypertension and dyslipidemia were 58% and 73%. Conclusion: The bariatric procedures are safe with a low complication rate. The procedures also provide good outcomes in postoperative weight loss and comorbidity resolution.

show abstract

“…63 Identified causal factors include a larger than normal gastric pouch (increased acid producing cells), stapled anastomoses, nonsteroidal anti-inflammatory medication use, and active smoking. 64 Common symptoms are epigastric pain with eating, but it can also present as a spontaneous perforation with peritonitis and signs of sepsis and thus require intervention by the acute care surgeon. Typical CT scan findings include free air in the upper anterior abdomen, oral contrast extravasation (if given), and free fluid in the upper abdomen (Fig.…”

Section: Late Complications (>30 Postoperative Days): Internal Hernia...mentioning

confidence: 99%

“…The incidence is 2% to 15% and varies by anastomotic techniques and patient populations 63 . Identified causal factors include a larger than normal gastric pouch (increased acid producing cells), stapled anastomoses, nonsteroidal anti-inflammatory medication use, and active smoking 64 . Common symptoms are epigastric pain with eating, but it can also present as a spontaneous perforation with peritonitis and signs of sepsis and thus require intervention by the acute care surgeon.…”

Section: Gastric Bypass Complicationsmentioning

confidence: 99%

Common postbariatric surgery emergencies for the acute care surgeon: What you need to know

Cheng,

Samakar,

Dobrowolsky

et al. 2023

J Trauma Acute Care Surg

View full text Add to dashboard Cite

The field of bariatric and metabolic surgery has changed rapidly over the past two decades, with an exponential increase in case volumes being performed because of its proven efficacy for morbid obesity and obesity-related comorbidities. Although this increased volume of procedures has been accompanied by significant decrease in postoperative complication rates, there are numerous potential complications after bariatric surgery that may require urgent or emergent surgical evaluation or interventions. Many of these risks extend well beyond the early postoperative period and can present months to years after the index procedure. Acute care surgeons are increasingly covering most or all of the emergency general surgery services at many centers and must be familiar with the numerous bariatric surgical procedures being performed and their individual complication profile to provide optimal care for these frequently challenging patients. This article provides a focused and concise review of the common bariatric procedures being performed, their early and late complication profiles, and a practical guide to the optimal diagnostic evaluations, surgical interventions, and perioperative management options. The author group includes both acute care surgeons and bariatric surgeons with significant experience in the emergency management of the complicated postbariatric surgical patient. LEVEL OF EVIDENCE Literature Synthesis and Expert Opinion; Level V.

show abstract

Which Factors Correlate with Marginal Ulcer After Surgery for Obesity?

Cited by 23 publications

References 56 publications

Aspirin Use as a Risk Factor for Marginal Ulceration in Roux-en-Y Gastric Bypass Patients: A Meta-Analysis of 24,770 Patients

Aspirin Use as a Risk Factor for Marginal Ulceration in Roux-en-Y Gastric Bypass Patients: A Meta-Analysis of 24,770 Patients

Surgical Outcomes of Bariatric Surgery in Siriraj Hospital for the First 100 Morbidly Obese Patients Treated

Common postbariatric surgery emergencies for the acute care surgeon: What you need to know

Contact Info

Product

Resources

About