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单吻合口胃旁路术后边缘溃疡穿孔:手术治疗及两年随访结果

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

作者信息

Abu-Abeid Adam, Litmanovich Adi, Yuval Jonathan Benjamin, Tome Jawad, Keidar Andrei, Eldar Shai Meron

机构信息

Division of General Surgery, Tel Aviv Sourasky Medical Center, Affiliated to Sackler Faculty of Medicine, Tel Aviv University, 6, Weizman St., Tel Aviv 6423906, Israel.

出版信息

J Clin Med. 2024 May 24;13(11):3075. doi: 10.3390/jcm13113075.

Abstract

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.

摘要

边缘溃疡(MU)穿孔是单吻合口胃旁路术(OAGB)后的一种慢性并发症。本研究的目的是分析因MU穿孔而接受OAGB翻修手术的患者,并描述其两年的预后情况。对一家三级医院数据库进行回顾性分析。纳入所有因MU穿孔而接受手术翻修的患者。在研究期间,22例患者因MU穿孔接受了OAGB翻修手术。MU穿孔发生率为0.98%。中位年龄为48岁,男性13例(59%)。从OAGB到MU穿孔的中位时间为19个月,总体重减轻中位数为31.5%。9例患者(41%)为吸烟者。19例患者(86%)进行了网膜修补(±一期缝合),3例患者(14%)改行Roux-en-Y胃旁路术(RYGB)。中位随访48个月时,3例患者(14%)诊断为复发性MU,其中1例发生复发性MU穿孔。4例患者(18%)在随访期间改行RYGB。MU穿孔是OAGB后的一种慢性并发症。在该队列中,大多数患者为男性且可能为吸烟者。网膜修补在大多数情况下有效。两年随访时复发性MU发生率可以接受。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a0e7/11172864/d0cf217f875c/jcm-13-03075-g001.jpg

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