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Development of Ulcer Disease After Roux-en-Y Gastric Bypass, Incidence, Risk Factors, and Patient Presentation: A Systematic Review

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Abstract

Laparoscopic Roux-en-Y gastric bypass (LRYGB) is the gold standard in bariatric surgery. A long-term complication can be marginal ulceration (MU) at the gastrojejunostomy. The mechanism of development is unclear and symptoms vary. Management and prevention is a continuous subject of debate. The aim was to assess the incidence, mechanism, symptoms, and management of MU after LRYGB by means of a systematic review. Forty-one studies with a total of 16,987 patients were included, 787 (4.6 %) developed MU. The incidence of MU varied between 0.6 and 25 %. The position and size of the pouch, smoking, and nonsteroidal inflammatory drugs usage are associated with the formation of MU. In most cases, MU is adequately treated with proton pump inhibitors, sometimes reoperation is required. Laparoscopic approach is safe and effective.

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Acknowledgments

SM Lagarde is supported by a Koningin Wilhelmina Fonds (KWF, Dutch Cancer Society Fellowship, UVA 2013-5853). Special thanks to Mrs. H. Swindin for her knowledge and assistance.

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Authors and Affiliations

  1. Department of Surgery, Sint Lucas Andreas Hospital, Jan Tooropstraat 164, 1061, Amsterdam, The Netherlands

    Usha K. Coblijn, Amin B. Goucham, Sjoerd M. Lagarde & Bart A. van Wagensveld

  2. Department of Gastroenterology, Sint Lucas Andreas Hospital, Amsterdam, The Netherlands

    Sjoerd D. Kuiken

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  1. Usha K. Coblijn
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  2. Amin B. Goucham
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Coblijn, U.K., Goucham, A.B., Lagarde, S.M. et al. Development of Ulcer Disease After Roux-en-Y Gastric Bypass, Incidence, Risk Factors, and Patient Presentation: A Systematic Review. OBES SURG 24, 299–309 (2014). https://doi.org/10.1007/s11695-013-1118-5

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