title: Marginal ulcer following gastric bypass for morbid obesity.
abstract: Four hundred twelve patients underwent gastric bypass for treatment of morbid obesity between 1981 and 1985 at the University of Florida Affiliated Hospitals. Thirty-four patients (8.2%) developed marginal ulcers, considerably higher than the 0-3 per cent ulcer occurrence commonly reported in the literature. Factors predisposing to ulcer formation include: (1) a large gastric pouch; (2) a vertically oriented pouch; and (3) staple-line dehiscence. Twenty-two of 34 patients (65%) with symptomatic marginal ulcers were noted to have staple-line disruption. Twenty-one of these patients (95%) eventually required operative therapy for their ulcers compared with four of 12 patients (33%) with an intact gastric staple line. Surgical therapy consisted of takedown of the Roux-en-Y limb with resection of the ulcer and gastrogastrostomy. Staple-line dehiscence is a significant etiologic factor in the development of marginal ulcer following gastric bypass and when present constitutes an indication for reoperation.
authors.affiliation: Department of Surgery, University of Florida, Gainesville 32610.
authors.forename: J H
authors.initials: JH
authors.lastname: Jordan
authors.forename: M P
authors.initials: MP
authors.lastname: Hocking
authors.forename: W R
authors.initials: WR
authors.lastname: Rout
authors.forename: E R
authors.initials: ER
authors.lastname: Woodward
mesh_terms: D000293:Adolescent; D000328:Adult; D015390:Gastric Bypass / Q000009:adverse effects*; D006801:Humans; D008875:Middle Aged; D009767:Obesity, Morbid / Q000601:surgery*; D012086:Reoperation; D013276:Stomach Ulcer / Q000209:etiology* / Q000628:therapy