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Background/ Aims: With the growing performance of bariatric surgery a subsequent increase in complications associated with this surgical procedure takes place. This research focuses at marginal ulceration (MU) after (laparoscopic) Roux-en Y Gastric Bypass surgery (LRYGB). Aim of this study was to asses the incidence, symptoms, mechanism and treatment of MU after LRYGB surgery.
Methods: All files of patients who underwent a LRYGB were searched for signs of abdominal pain, epigastric burn, nausea or other symptoms of ulcer disease. Also symptoms of (perforated) MU as acute abdominal pain, vomiting, melaena and haematemesis were scored. Possible contributing factors were identified. Results of medical and surgical treatment were evaluated.
Results: 419 patients underwent LRYGB. 26 (6.2 %) of them developed MU of which five (1.2%) presented with perforation. The use of non-steroidal inflammatory drugs (NSAIDs), smoking and prednisolon- inhalation corticosteroids significantly contributed to the development of MU. Five patients needed reoperation. All other patients could be treated conservative with proton pump inhibitors occasionally together with Ulcogant ®.
Conclusion: marginal ulceration after LRYGB is more frequently being recognized as a major problem due to the increase in bariatric procedures. The use of nicotine and NSAIDs must be stopped and inhalation corticosteroids should be minimized.