Benefits of Prophylactic Proton Pump Inhibitors after Roux-en-Y Gastric Bypass Surgery: A Retrospective Study.

ABSTRACT

BACKGROUND: Worldwide, proton pump inhibitors (PPIs) are frequently used to prevent marginal ulcers after Roux-en-Y gastric bypass (RYGB) surgery. The aim of this retrospective study was to assess the prophylactic value of PPIs after a RYGB. METHODS: We retrospectively collected data on 200 patients with morbid obesity, who underwent RYGB surgery between August 2012 and August 2013. The patients were further divided into two groups according to whether or not they had been given prophylactic PPIs after the RYGB. Marginal ulcers were diagnosed based on reported symptoms and confirmed by endoscopy. RESULTS: The average follow-up time was 6.7 months. Postoperative gastroscopy was performed in 23 patients. A marginal ulcer was diagnosed in 13 patients. Only four of these patients were taking prophylactic PPIs, of which three patients had already started taking them prior to surgery. Although marginal ulcers occurred less frequently in patients undergoing prophylactic treatment with PPIs (p-value 0.200), we were unable to demonstrate any statistically significant reduction in the number of ulcers. In addition, major risk factors such as nicotine abuse, NSAIDS and H. pylori did not appear to influence the incidence. CONCLUSIONS: Although our results suggest that PPIs reduce the incidence of marginal ulcers, we were unable to confirm this statistically. Our study was limited by the small study population and short follow-up period. In light of the lack of available scientific evidence and the growing problem of obesity, we believe that robust, large-scale prospective studies are necessary.