Marginal Ulcer Perforation after One Anastomosis Gastric Bypass: Surgical Treatment and Two-Year Outcomes

• Published in: Journal of clinical medicine 2024-05, Vol.13 (11), p.3075
• Main Authors: Abu-Abeid, Adam, Litmanovich, Adi, Yuval, Jonathan Benjamin, Tome, Jawad, Keidar, Andrei, Eldar, Shai Meron
• Format: Article
• Language: English
• Subjects: Abdomen; Body mass index; Disease prevention; Endoscopy; Ethics; Gastric bypass; Gastrointestinal surgery; Laparoscopy; Normal distribution; Obesity; Pantoprazole; Statistical analysis; Surgery; Sutures; Type 2 diabetes; Ulcers; Weight control
• ISSN: 2077-0383; 2077-0383
• DOI: 10.3390/jcm13113075

Marginal ulcer (MU) perforation is a chronic complication after One-anastomosis Gastric Bypass (OAGB). This study's purpose was to analyze patients undergoing OAGB revision due to MU perforation and describe the two-year outcomes. A retrospective analysis of a database in a single-tertiary hospital. All patients undergoing surgical revision due to MU perforation were included. During the study period, 22 patients underwent OAGB revision due to MU perforation. The rate of MU perforation was 0.98%. The median age was 48 years and there were 13 men (59%). The median time from OAGB to MU perforation was 19 months with a median total weight loss of 31.5%. Nine patients (41%) were smokers. Omental patch (±primary closure) was performed in 19 patients (86%) and three patients (14%) underwent conversion to Roux-en-Y gastric bypass (RYGB). At a median follow-up of 48 months, three patients (14%) had recurrent MU diagnosis, of which one had a recurrent MU perforation. Four patients (18%) underwent conversion to RYGB during follow-up. MU perforation is a chronic complication after OAGB. In this cohort, most patients were men and likely to be smokers. Omental patch was effective in most cases. Recurrent MU rates at two years follow-up were acceptable.