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vol.67 número1CARACTERIZACIÓN DEL INFILTRADO LINFOCITARIO (CD3, CD4, CD8, CD45RO Y FOXP3) E INESTABILIDAD MICRO-SATELITAL EN PACIENTES CON CÁNCER COLORRECTALNEFRECTOMÍA LAPAROSCÓPICA DE DONANTE VIVO: EXPERIENCIA DE 75 CASOS CONSECUTIVOS índice de autoresíndice de materiabúsqueda de artículos
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Revista chilena de cirugía

versión On-line ISSN 0718-4026

Resumen

MARAMBIO G, Andrés et al. Perforated marginal ulcer after laparoscopic gastric bypass. Rev Chil Cir [online]. 2015, vol.67, n.1, pp.51-56. ISSN 0718-4026.  http://dx.doi.org/10.4067/S0718-40262015000100008.

Introduction: Perforated marginal ulcer is a serious event that usually requires reoperation and is associated with morbidity and mortality. Characterization and management of these patients is still debated. Objective: To describe a series of patients subjected to a laparoscopic gastric bypass (LGBP) that evolved with a perforated marginal ulcer. Material and Methods: Records of patients undergoing a LGBP the last 10 years and evolved with a perforated marginal ulcer were retrospectively reviewed. Clinical features, treatment and perioperative morbidity and mortality were analyzed. Results: During this period 2,095 patients were subjected to a LGBP, 12 of them presented a perforated marginal ulcer, corresponding to 10 women and 2 men. Mean age was 39 (21-60) and mean body mass index at the time of initial surgery was 34 (29.3 to 38.6). Ten patients were smoker at the moment of perforation. The occurrence of this happened at a mean of 27 months (range 3-54, median 23.5) after surgery. Eleven cases had a surgical resolution, with a laparoscopic approach in 9 of them and laparotomy on 2. In all cases, a perforated ulcer in the jejunal side of the gastro-jejunal anastomosis was found. There was no mortality or morbidity associated with surgery. Conclusions: In our experience the occurrence of perforated marginal ulcer after a LGBP develops in a small percentage of patients. The laparoscopic approach is of choice, presenting a low morbidity and mortality. Smoking was present in most patients.

Palabras clave : Perforated ulcer; marginal ulcer; gastric bypass.

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