An evidence-based algorithm for the management of marginal ulcers following Roux-en-Y gastric bypass.
As the demand for obesity surgery grows, Roux-en-Y gastric bypass remains the most commonly performed procedure associated with low complication rates and good long-term co-morbidity resolution and weight loss. Marginal ulcers remain a cause of significant morbidity in medium and long term and are reported in every large series of this operation. Marginal ulceration is a complex problem with unclear aetiology and lack of clear consensus on its prevention and management. A clearer understanding of the available evidence regarding the prevention and treatment of marginal ulcers is needed to improve patient care. We propose an algorithm for management of patients with marginal ulcers based on the best available evidence in the literature.
Bariatric Unit, Sunderland Royal Hospital, Sunderland, SR4 7TP, UK, wrjcarr@doctors.org.uk.
William R J
WR
Carr
Kamal K
KK
Mahawar
Shlok
S
Balupuri
Peter K
PK
Small
D000465:Algorithms; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D000897:Anti-Ulcer Agents / Q000627:therapeutic use*; D015897:Comorbidity; D015390:Gastric Bypass; D016481:Helicobacter Infections / Q000150:complications / Q000188:drug therapy*; D006801:Humans; D007579:Jejunal Diseases / Q000517:prevention & control* / Q000628:therapy; D009767:Obesity, Morbid / Q000150:complications / Q000601:surgery*; D010437:Peptic Ulcer / Q000188:drug therapy / Q000517:prevention & control*; D011183:Postoperative Complications / Q000517:prevention & control* / Q000628:therapy; D054328:Proton Pump Inhibitors / Q000627:therapeutic use; D016540:Smoking Cessation
D000900:Anti-Bacterial Agents; D000897:Anti-Ulcer Agents; D054328:Proton Pump Inhibitors