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 Surgjournal_title
Obesity surgeryauthors
Plitzko G,Schmutz G,Kröll D,Nett PC,Borbély Ydoi
10.1007/s11695-020-05123-wsubject
Has Abstractpub_date
2020-11-24 00:00:00eissn
0960-8923issn
1708-0428pii
10.1007/s11695-020-05123-wpub_type
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