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Predictors of marginal ulcer after gastric bypass: a systematic review and meta-analysis.
- Source :
-
Journal of Gastrointestinal Surgery . Jun2023, Vol. 27 Issue 6, p1066-1077. 12p. - Publication Year :
- 2023
-
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. [ABSTRACT FROM AUTHOR]
Details
- Language :
- English
- ISSN :
- 1091255X
- Volume :
- 27
- Issue :
- 6
- Database :
- Academic Search Index
- Journal :
- Journal of Gastrointestinal Surgery
- Publication Type :
- Academic Journal
- Accession number :
- 164305904
- Full Text :
- https://doi.org/10.1007/s11605-023-05619-7