Early Marginal Ulcer After Roux-en-Y Gastric Bypass: MBSAQIP Database Analysis of Trends and Predictive Factors

Area of Science:

• Bariatric Surgery
• Gastrointestinal Surgery
• Surgical Complications

Background:

• Marginal ulcer (MU) is a significant complication following Roux-en-Y gastric bypass (RYGB).
• MU can lead to substantial patient morbidity and healthcare resource utilization.

Purpose of the Study:

• To determine the incidence, readmission, reintervention, and reoperation rates for 30-day MU after RYGB.
• To identify predictive factors associated with the development of 30-day MU.

Main Methods:

• Analysis of the 2015-2021 MBSAQIP database for patients undergoing laparoscopic RYGB (LRYGB).
• Inclusion criteria: 30-day MU post-LRYGB; exclusion: other 30-day complications.
• Statistical analysis included bivariate and logistic regression.

Main Results:

• The incidence of 30-day MU was 0.3% (638/213,104 patients).
• Patients with 30-day MU had high rates of endoscopic intervention (88%), readmission (72%), and reoperation (9%).
• Predictive factors included renal insufficiency, DVT history, cardiac stent, African American race, steroid use, COPD, anticoagulation, anastomotic leak test, GERD, and operative time >120 min.

Conclusions:

• The incidence of 30-day MU after RYGB is low but associated with significant intervention and readmission needs.
• Several preoperative and intraoperative factors are associated with an increased risk of 30-day MU.
• Early identification of at-risk patients may guide preventative strategies.