Article ; Online: Predictors of marginal ulcer after gastric bypass: a systematic review and meta-analysis.
2023 Volume 27, Issue 6, Page(s) 1066–1077
Abstract: Introduction: Marginal ulcer (MU) is a common complication following Roux-en-Y gastric bypass (RYGB) with an incidence rate of up to 25%. Several studies have evaluated different risk factors associated with MU with inconsistent findings. In this meta- ... ...
Abstract | Introduction: Marginal ulcer (MU) is a common complication following Roux-en-Y gastric bypass (RYGB) with an incidence rate of up to 25%. Several studies have evaluated different risk factors associated with MU with inconsistent findings. In this meta-analysis, we aimed to identify the predictors of MU after RYGB. Methods: A comprehensive literature search of PubMed, Embase, and Web of Science databases was conducted through April 2022. All studies that used a multivariate model to assess risk factors for MU after RYGB were included. Pooled odds ratios (OR) with 95% confidence intervals (CI) for risk factors reported in ≥ 3 studies were obtained within a random-effects model. Results: Fourteen studies with 344,829 patients who underwent RYGB were included. Eleven different risk factors were analyzed. Meta-analysis demonstrated that Helicobacter pylori (HP) infection (OR 4.97 [2.24-10.99]), smoking (OR 2.50 [1.76-3.54]), and diabetes mellitus (OR 1.80 [1.15-2.80]), were significant predictors of MU. Increased age, body mass index, female gender, obstructive sleep apnea, hypertension, and alcohol use were not predictors of MU. There was a trend of an increased risk of MU associated with nonsteroidal anti-inflammatory drugs (OR 2.43 [0.72-8.21]) and a lower risk of MU with proton pump inhibitors use (OR 0.44 [0.11-2.11]). Conclusions: Smoking cessation, optimizing glycemic control, and eradication of HP infection reduce the risk of MU following RYGB. Recognition of predictors of MU after RYGB will allow physicians to identify high-risk patients, improve surgical outcomes, and reduce the risk of MU. |
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MeSH term(s) | Humans ; Female ; Gastric Bypass/adverse effects ; Peptic Ulcer/etiology ; Peptic Ulcer/surgery ; Risk Factors ; Proton Pump Inhibitors ; Hypertension/complications ; Obesity, Morbid/surgery ; Obesity, Morbid/complications ; Retrospective Studies |
Chemical Substances | Proton Pump Inhibitors |
Language | English |
Publishing date | 2023-02-16 |
Publishing country | United States |
Document type | Meta-Analysis ; Systematic Review ; Journal Article |
ZDB-ID | 2012365-6 |
ISSN | 1873-4626 ; 1934-3213 ; 1091-255X |
ISSN (online) | 1873-4626 ; 1934-3213 |
ISSN | 1091-255X |
DOI | 10.1007/s11605-023-05619-7 |
Database | MEDical Literature Analysis and Retrieval System OnLINE |
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