Can a short course of prophylactic low-dose proton pump inhibitor therapy prevent stomal ulceration after laparoscopic Roux-en-Y gastric bypass?
BACKGROUND
The purpose of this retrospective analysis was to determine if a short course of prophylactic proton pump inhibitor (PPI) therapy can prevent stomal ulceration after laparoscopic Roux-en-Y gastric bypass (LRYGBP).


METHODS
Four hundred forty-nine consecutive patients who underwent LRYGBP and had a minimum of 6 months follow-up were included. Patients were categorized in two groups: patients with Helicobacter pylori at preoperative endoscopy (HP group) and patients without H. pylori (non-HP group). All patients in the HP group were medically treated prior to surgery. In both groups, almost half of the patients received low-dose proton pump inhibitors (omeprazole 20 mg daily) for 1 month following LRYGBP.


RESULTS
The incidence of stomal ulceration in the HP group was not statistically different from the incidence in the non-HP group (7/86, 8.14% vs. 41/363, 11.29%; p = 0.559). When comparing the patients who did receive PPI therapy with the patients who did not receive PPI therapy within the non-HP group, there was no significant reduction in development of stomal ulceration (18/169, 10.65% vs. 23/194, 11.86%; p = 0.743). When comparing the patients who did receive PPI therapy with the patients who did not receive PPI therapy within the HP group, there is a significant reduction in development of stomal ulceration (0/41, 0% vs. 7/45, 15.56%; p = 0.0123).


CONCLUSIONS
Development of stomal ulceration in patients tested positive for H. pylori prior to LRYGBP can be prevented by prophylactic low-dose PPI therapy following surgery.
D'Hondt
Mathieu André
MA
Groeninge Hospital, Houtmarkt 33, 8500 Kortrijk, Belgium. mathieudhondt2000@yahoo.com
Pottel
Hans
H
Devriendt
Dirk
D
Van Rooy
Frank
F
Vansteenkiste
Franky
F
D000293:Adolescent; D000328:Adult; D000368:Aged; D005260:Female; D015390:Gastric Bypass / Q000379:methods*; D016481:Helicobacter Infections / Q000188:drug therapy*; D016480:Helicobacter pylori; D006801:Humans; D010535:Laparoscopy / Q000379:methods; D008297:Male; D008875:Middle Aged; D009767:Obesity, Morbid / Q000601:surgery; D054328:Proton Pump Inhibitors / Q000627:therapeutic use*; D012189:Retrospective Studies; D013276:Stomach Ulcer / Q000453:epidemiology / Q000517:prevention & control*; D016896:Treatment Outcome; D055815:Young Adult
D054328:Proton Pump Inhibitors