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Ulcers after Bariatric Surgery
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Ulcers after Bariatric Surgery

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Gastroenterology & Hepatopancreatobiliary Medicine".

Deadline for manuscript submissions: 15 January 2025 | Viewed by 1556

Special Issue Editors

Prof. Dr. Vincenzo Pilone

E-Mail Website
Guest Editor
Department of Public Health, University of Naples Federico II, Via Pansini 5, 80131 Naples, Italy
Interests: bariatric surgery; gastrectomy; ulcers
Special Issues, Collections and Topics in MDPI journals
Dr. Antonio Vitiello

E-Mail Website1 Website2
Guest Editor
Department of Advanced Biomedical Sciences, University of Naples “Federico II”, Via S. Pansini, 5, 80131 Naples, Italy
Interests: gastric bypass; bariatric surgery; sleeves
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Metabolic bariatric surgery is currently considered the best treatment for morbid obesity. Sleeve gastrectomy and Roux-en-Y gastric bypass are the most common interventions, but new procedures have spread worldwide. Marginal ulcers (MU) are a well-known complication following new and old metabolic interventions. Even if most of these ulcers respond to medical treatment, recurrent or chronic MU may require revisional intervention. The etiology is multifactorial, and non-steroidal anti-inflammatory drug (NSAID) use, smoking, and Helicobacter pylori infection have been advocated as risk factors for MU. However, mechanisms beyond the formation of recalcitrant ulcers have not yet been clarified, nor has the best treatment.

The aim of this Special Issue is to report the rate of MU after new bariatric procedures such as one anastomosis gastric bypass, single anastomosis sleeve-ileal bypass, or single anastomosis duodeno-ileal bypass and to further investigate the relationship between known risk factors and marginal ulcer (MU) formation, especially after revisional procedures.

Prof. Dr. Vincenzo Pilone
Dr. Antonio Vitiello
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Journal of Clinical Medicine is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • marginal ulcer
  • sleeve gastrectomy
  • Roux-en-Y gastric bypass
  • one anastomosis gastric bypass
  • single anastomosis sleeve-ileal bypass
  • single anastomosis duodeno-ileal bypass
  • LSG
  • RYGB
  • OAGB
  • SASI
  • SADI

Published Papers (3 papers)

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Research

12 pages, 787 KiB  
Article
Does Antrum Size Matter in Sleeve Gastrectomy? Volume II—A Retrospective Multicentric Study with Long-Term Follow-Up
by Claudio Gambardella, Simona Parisi, Salvatore Tolone, Francesco Saverio Lucido, Gianmattia del Genio, Luigi Brusciano, Rosetta Esposito, Domenico de Vito, Ludovico Docimo and Francesco Pizza
J. Clin. Med. 2024, 13(13), 3912; https://doi.org/10.3390/jcm13133912 - 3 Jul 2024
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Abstract
Background: Laparoscopic sleeve gastrectomy (LSG) is the most widespread bariatric procedure due to its safety and efficacy. Despite continuous refinement, achieving a globally standardized procedure remains challenging. Moreover, due to its wide adoption, numerous studies have focused on complications associated with the technique, [...] Read more.
Background: Laparoscopic sleeve gastrectomy (LSG) is the most widespread bariatric procedure due to its safety and efficacy. Despite continuous refinement, achieving a globally standardized procedure remains challenging. Moreover, due to its wide adoption, numerous studies have focused on complications associated with the technique, such as gastroesophageal reflux disease (GERD). This study evaluates the impact of antrum size (wide antrectomy versus small antrectomy) in LSG on long-term anthropometric outcomes and complications in patients with morbid obesity. Methods: Body mass index (BMI), percentage of excess weight loss (%EWL) at a 5-year follow-up, GERD Health-Related Quality-of-Life (GERD-HRQL) scores, and obesity-related diseases of patients undergoing LSG with gastric resections starting 2 cm and 6 cm from the pylorus were retrospectively evaluated. Results: Between January 2015 and November 2019, 597 patients who met the criteria for LSG were included in the study. Group A (241 patients) underwent wide antrectomy, while Group B (356 patients) underwent small antrectomy. Weight, BMI, %EWL, and %TWL significantly improved at 6 and 12 months in the wide-antrectomy group. However, these differences diminished by 24 months, with no significant long-term differences in weight loss outcomes between the two groups at 5 years. Conversely, GERD-HRQL scores were significantly better in the small-antrectomy group until 24 months; thereafter, results were comparable between groups over the long term. Conclusions: Therefore, while wide antrectomy may offer superior short-term anthropometric outcomes, both techniques yield similar long-term results regarding weight management and GERD incidence. Larger prospective studies are needed to further address this issue. Full article
(This article belongs to the Special Issue Ulcers after Bariatric Surgery)
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7 pages, 522 KiB  
Article
Staple Line Reinforcement during Sleeve Gastrectomy with SeamGuard: Single-Center Retrospective Case-Control Study over a 5-Year Period
by Antonio Vitiello, Jessica Mok, Mohamed Elkalaawy, Andrea Pucci, Andrew Jenkinson, Rachel Battheram, Vincenzo Pilone and Marco Adamo
J. Clin. Med. 2024, 13(12), 3410; https://doi.org/10.3390/jcm13123410 - 11 Jun 2024
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Abstract
Introduction: Various techniques and reinforcements have been proposed over the years in order to prevent leaks and bleeding after sleeve gastrectomy (LSG). The aim of this study was to retrospectively compare the staple line complication (SLC) rate in patients who underwent LSG with [...] Read more.
Introduction: Various techniques and reinforcements have been proposed over the years in order to prevent leaks and bleeding after sleeve gastrectomy (LSG). The aim of this study was to retrospectively compare the staple line complication (SLC) rate in patients who underwent LSG with the use of bioabsorbable membrane (GORE® SEAMGUARD®, GoR) for staple line versus those who received no reinforcement. Methods: Data on all consecutive patients undergoing LSG between 1 January 2014 and 31 December 2018 were retrospectively reviewed. Patients were divided into two groups: the GoR+ group if the SeamGuard (GoR) was used and the GoR− group if no reinforcement was applied on the staple line. Preoperative demographics and rate of SLC were compared between groups. All cases of SLC coming from other centers were also reviewed. Results: A total number of 626 LSGs were performed at our institution during the study period. GoR was applied in 450 (71.9%) cases (GoR+ group), while NR was used in 176 (28.1%) patients (GoR− group). Two (1.13%) cases of leaking and two (1.13%) cases of bleeding occurred in the GoR− group, while no SLC was recorded in patients who received GoR (p < 0.05). Thirteen cases of SLC coming from other institutions were treated at our hospital; all these cases were performed without any SLR. Conclusion: In our case series, the use of GoR reduced the rate of SLC after LSG. In all cases of SLC coming from other institutions, no reinforcement had been applied on the staple line during LSG. Full article
(This article belongs to the Special Issue Ulcers after Bariatric Surgery)
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10 pages, 521 KiB  
Article
Marginal Ulcer Perforation after One Anastomosis Gastric Bypass: Surgical Treatment and Two-Year Outcomes
by Adam Abu-Abeid, Adi Litmanovich, Jonathan Benjamin Yuval, Jawad Tome, Andrei Keidar and Shai Meron Eldar
J. Clin. Med. 2024, 13(11), 3075; https://doi.org/10.3390/jcm13113075 - 24 May 2024
Viewed by 528
Abstract
Background: 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. Methods: A retrospective analysis of a database in a single-tertiary [...] Read more.
Background: 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. Methods: A retrospective analysis of a database in a single-tertiary hospital. All patients undergoing surgical revision due to MU perforation were included. Results: 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. Conclusions: 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. Full article
(This article belongs to the Special Issue Ulcers after Bariatric Surgery)
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