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- Bekhali, Zakaria, 1969-, et al.
(författare)
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Low Risk for Marginal Ulcers in Duodenal Switch and Gastric Bypass in a Well-Defined Cohort of 472 Patients
- 2020
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Ingår i: Obesity Surgery. - : Springer Nature. - 0960-8923 .- 1708-0428. ; 30:11, s. 4422-4427
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: Marginal ulcer (MU) is well-known complication in bariatric surgery. Several studies are available in Roux-en-Y gastricbypass (RYGBP), while data on the incidence in duodenal switch (DS) is limited. We aimed to compare the incidence of MUbetween DS and RYGBP in a well-defined cohort and to identify associative factors.Methods: A cohort of 732 patients with BMI ≥ 48 who had undergone primary DS or RYGBP during 2008–2018 received aquestionnaire concerning ulcers, PPI therapy, and smoking habits; hereafter, patient charts were reviewed. Incidence rates (IRs)for MU were calculated in our survey and on previous registered data in the national quality register for bariatric surgery(SOReg). A multivariate regression analysis was performed to identify predictive risk factors for MU.Results: After a mean follow-up of 6.1 years, 472 (64%) patients responded (47 ± 11 years old, 65% women and 42% DS). Of 41MUs identified, 23 were endoscopically verified. Gastrointestinal bleeding, abdominal pain, and dysphagia were the mostcommon symptoms. IR for MU was 1.4% (DS 1.3% and RYGBP 1.5%) per patient-year, compared with 0.9% according toSOReg-data. Persisting PPI treatment was seen in about three quarter of formerMUpatients (OR 11.2 [3.6–34.7], p < 0.001), butno other associative factors were found.Conclusion: The overall risk for MU was low, about 1% per patient-year, without difference between DS and RYGBP. OngoingPPI treatment was frequent in many former MU patients. This study on MU after DS provides reassuring results for futurebariatric surgery candidates.
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