Ulcer Disease in the Excluded Segments after Roux-en-Y Gastric Bypass: a Current Review of the Literature.

Abstract:

:Ulcer disease in excluded segments after Roux-Y gastric bypass (RYGB) is rare but can evolve into a life-threatening situation. The excluded segments exhibit a different behavior from that of non-altered anatomy; perforated ulcers do not result in pneumoperitoneum or free fluid, and therefore must be met with a low threshold for surgical exploration. The anatomical changes after RYGB impede routine access to the remnant stomach and duodenum. There are various options to address bleeding or perforated ulcers. While oversewing and drainage preserves the anatomy and forgoes resection, remnant gastrectomy offers a definitive solution. The importance of traditional risk factors such as smoking or use of non-steroidal anti-inflammatory drugs is unclear. Eradication of Helicobacter pylori and secondary prophylaxis with proton-pump inhibitors is advisable, albeit in double-dose.

journal_name

Obes Surg

journal_title

Obesity surgery

authors

Plitzko G,Schmutz G,Kröll D,Nett PC,Borbély Y

doi

10.1007/s11695-020-05123-w

subject

Has Abstract

pub_date

2020-11-24 00:00:00

eissn

0960-8923

issn

1708-0428

pii

10.1007/s11695-020-05123-w

pub_type

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