Ulcer Disease in the Excluded Segments after Roux-en-Y Gastric Bypass : a Current Review of the Literature
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.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2021 |
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| Erschienen: |
2021 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:31 |
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| Enthalten in: |
Obesity surgery - 31(2021), 3 vom: 23. März, Seite 1280-1289 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Plitzko, Gabriel [VerfasserIn] |
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| Links: |
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| Anmerkungen: |
Date Completed 19.04.2021 Date Revised 01.07.2021 published: Print-Electronic Citation Status MEDLINE |
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| doi: |
10.1007/s11695-020-05123-w |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM317976648 |
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| 500 | |a Citation Status MEDLINE | ||
| 520 | |a 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 | ||
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| 650 | 4 | |a Review | |
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| 650 | 4 | |a Gastric remnant | |
| 650 | 4 | |a Gastritis | |
| 650 | 4 | |a Gastrostomy | |
| 650 | 4 | |a Hemorrhage | |
| 650 | 4 | |a Morbid obesity | |
| 650 | 4 | |a Non-steroidal anti-inflammatory drugs | |
| 650 | 4 | |a Peptic ulcer perforation | |
| 650 | 4 | |a Roux-Y gastric bypass | |
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| 700 | 1 | |a Kröll, Dino |e verfasserin |4 aut | |
| 700 | 1 | |a Nett, Philipp C |e verfasserin |4 aut | |
| 700 | 1 | |a Borbély, Yves |e verfasserin |4 aut | |
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