Predictors of Endoscopic Findings After Roux-en-Y Gastric Bypass

  title={Predictors of Endoscopic Findings After Roux-en-Y Gastric Bypass},
  author={Jason A. Wilson and Joseph Romagnuolo and Thomas Karl Byrne and Katherine A. Morgan and Frederick A. Wilson},
  journal={The American Journal of Gastroenterology},
OBJECTIVES:To evaluate predictors of endoscopic findings in symptomatic patients after Roux-en-Y gastric bypass (RYGBP) for obesity.METHODS:A retrospective chart review of 1,001 RYGBP procedures was performed. Two hundred twenty-six (23%) patients were identified as having endoscopy to evaluate upper gastrointestinal symptoms following surgery. Polychotomous logistic regression analysis was used to assess predictors of normal endoscopy, marginal ulcers, stomal stenosis, and staple-line… 

Figures and Tables from this paper

Marginal ulceration after Roux-en-Y gastric bypass surgery: characteristics, risk factors, treatment, and outcomes.
Diabetes, smoking, and long gastric pouches were significant risk factors for marginal ulcers formation, suggesting increased acid exposure and mucosal ischemia are both involved in marginal ulcer pathogenesis.
Marginal ulcer after Roux-en-Y gastric bypass: what have we really learned?
Patients with pain or dysphagia after gastric bypass warrant upper endoscopy given the high yield for abnormalities, and a thorough investigation for potential etiologies including tobacco, alcohol, and nonsteroidal antiinflammatory drug (NSAID) usage should be determined and eliminated.
Management of Anastomotic Ulcers After Roux-en-Y Gastric Bypass: Results of an International Survey
The majority of bariatric surgeons recommend preoperative screening and eradication of H. pylori as well as prophylactic use of proton pump inhibitors if an AU is diagnosed, and the role of PPI as a first-line treatment seems to be undisputed.
Endoscopic Findings of Asymptomatic Patients One Year After Roux-en-Y Gastric Bypass for Treatment of Obesity
The study evaluated the endoscopic findings from asymptomatic obese patients after Roux-en-Y gastric bypass and correlate them with the demographic data and the presence of Helicobacter pylori to find an upper GIE at the end of their first post-operative year plays an important role.
Endoscopy Is Accurate, Safe, and Effective in the Assessment and Management of Complications Following Gastric Bypass Surgery
Patients presenting with UGI symptoms less than 3 months after surgery are more likely to have an abnormal finding on endoscopy, and endoscopic balloon dilation is safe and effective in managing anastomotic strictures.
Upper endoscopy after Roux-en-Y gastric bypass: diagnostic yield and factors associated with relevant findings.
Anastomotic Stricture Formation after Roux-En-Y Gastric Bypass Surgery: A Single Center Retrospective Cohort Study
After gastric bypass, proton pump inhibitor use and marginal ulceration were associated with anastomotic stricture formation, and there was a strong trend in patients with obstructive sleep apnea.
Management and treatment outcomes of marginal ulcers after Roux-en-Y gastric bypass at a single high volume bariatric center.
Surgical Technique Affects the Incidence of Marginal Ulceration after Roux-en-Y in Gastric Bypass
The incidence of MU after RYGB surgery is influenced by surgical technique, and the lowest incidence was with a non-divided stomach, no vagotomy, transverse staple line, and circular stapled anastomosis.
The hidden endoscopic burden of Roux-en-Y gastric bypass surgery
RYGB anastomotic strictures can be safely managed by dilatation, and if bariatric surgery is performed locally, endoscopy departments must expect to factor in, not only the burden of dealing with actual complications, but also theurden of investigating for potential complications.


Endoscopy after Roux-en-Y Gastric Bypass: A Community Hospital Experience
In patients who have had RYGBP, symptoms were a poor predictor of endoscopic pathology, and ulcer disease was the most common endoscopic finding.
Flexible Endoscopy in the Management of Patients Undergoing Roux-en-Y Gastric Bypass
Upper endoscopy is a tool which may be used by the surgeon in the preoperative and postoperative management of patients undergoing RYGBP to modify therapy, improve outcomes, and diagnose and treat postoperative complications.
Marginal Ulcer After Gastric Bypass: A Prospective 3-Year Study of 173 Patients
A preliminary impression that NTGB is an effective operation in preventing MU formation is confirmed and specific recommendations to reduce its occurrence are offered.
Laparoscopic management of complications following laparoscopic Roux-en-Y gastric bypass for morbid obesity
A variety of complications can present after Roux-en-Y gastric bypass, and laparoscopy is an excellent technique to treat these complications.
Peptic Ulcer/Stricture After Gastric Bypass: A Comparison of Technique and Acid Suppression Variables
U/S after GBP does not appear to be explained by acid injury, and it is speculated that local, tissue injury related factors may be more responsible, a speculation that invokes a novel pathophysiologic mechanism for U/S formation following gastrojejunostomy.
Complications of the Laparoscopic Roux-en-Y Gastric Bypass: 1,040 Patients - What Have We Learned?
The laparoscopic Roux-en-Y gastric bypass for morbid obesity with a totally hand-sewn gastrojejunostomy can be safely performed by the bariatric surgeon with advanced laparoscopically skills in the community setting.
Stenosis of the Gastroenterostomy after Laparoscopic Gastric Bypass
Stenosis of the gastroenterostomy after laparoscopic Roux-en-Y gastric bypass (LRYGBP) is an infrequent but serious problem, which results in considerable morbidity.
The Impact of Small Bowel Resection on the Incidence of Stomal Stenosis and Marginal Ulcer After Gastric Bypass
There is a trend towards a decrease in the incidence of SS in gastric bypass patients with concomitant SBR although this did not reach clinical significance.
Band Erosion: Incidence, Etiology, Management and Outcome after Banded Vertical Gastric Bypass
Band erosion or migration into the gastric lumen is an uncommon complication of transected banded vertical gastric bypass and is best managed by endoscopic removal but can be treated expectantly or by open surgical intervention.