PMID- 25159641
OWN - NLM
STAT- MEDLINE
DCOM- 20151215
LR  - 20211021
IS  - 1432-2218 (Electronic)
IS  - 0930-2794 (Linking)
VI  - 29
IP  - 5
DP  - 2015 May
TI  - Prophylactic PPI help reduce marginal ulcers after gastric bypass surgery: a 
      systematic review and meta-analysis of cohort studies.
PG  - 1018-23
LID - 10.1007/s00464-014-3794-1 [doi]
AB  - BACKGROUND: Marginal ulceration after gastric bypass surgery is a recognized 
      complication and has been reported in 1-16% of patients. There is evidence that 
      acidity may play a role in the disease pathophysiology and it is a common 
      practice for bariatric surgeons to begin a prophylactic course of proton pump 
      inhibitors (PPI), postoperatively. METHODS: MEDLINE, EMBASE, CINAHL, and the 
      Cochrane Controlled Trials Register were searched using the most comprehensive 
      timeline for each database up to January 2012. Studies that included patients 
      undergoing gastric bypass who received a prophylactic course of PPI 
      postoperatively were eligible. Two reviewers independently selected trials and 
      extracted data. The primary outcome was the incidence of marginal ulcers 
      diagnosed on the basis of endoscopic findings. Inverse variance random effects 
      models were used to estimate odds ratio (OR) and weighted proportion of ulcers. 
      Odds ratio and weighted pooled proportion with corresponding 95% confidence 
      intervals (CI) are reported. RESULTS: The strategic search identified 167 
      citations. A total of seven studies involving 2,917 participants were eligible 
      for inclusion and 2,114 were used for analysis. The weighted pooled proportion of 
      ulcer formation in PPI groups including all seven studies (four single group 
      cohort studies and PPI arm of three cohort studies) was 5.0% [95% CI 2-10%] (N = 
      1,407). The OR of marginal ulcer formation comparing PPI to no PPI for three 
      comparative cohort studies was 0.50 [95% CI 0.28-0.90, p = 0.02] (N = 1,022) with 
      low heterogeneity (I(2) = 12%) showing that the PPI group significantly 
      experienced twice less ulceration with PPI treatment compared to no PPI 
      treatment. CONCLUSION: This finding suggests a significant incremental benefit of 
      prophylactic PPI in reducing marginal ulcer after gastric bypass surgery. 
      Prospective randomized trials are needed to further define the role of PPI 
      following gastric bypass surgery.
FAU - Ying, Valerie Wu Chao
AU  - Ying VW
AD  - General Surgery, McMaster University, Hamilton, ON, Canada, 
      valerie.wuchaoying@medportal.ca.
FAU - Kim, Song Hon H
AU  - Kim SH
FAU - Khan, Khurram J
AU  - Khan KJ
FAU - Farrokhyar, Forough
AU  - Farrokhyar F
FAU - D'Souza, Joanne
AU  - D'Souza J
FAU - Gmora, Scott
AU  - Gmora S
FAU - Anvari, Mehran
AU  - Anvari M
FAU - Hong, Dennis
AU  - Hong D
LA  - eng
PT  - Journal Article
PT  - Meta-Analysis
PT  - Review
PT  - Systematic Review
DEP - 20140827
PL  - Germany
TA  - Surg Endosc
JT  - Surgical endoscopy
JID - 8806653
RN  - 0 (Proton Pump Inhibitors)
SB  - IM
MH  - Follow-Up Studies
MH  - Gastric Bypass/*adverse effects
MH  - Humans
MH  - Peptic Ulcer/etiology/*prevention & control
MH  - Postoperative Complications/etiology/*prevention & control
MH  - Proton Pump Inhibitors/*therapeutic use
EDAT- 2014/08/28 06:00
MHDA- 2015/12/17 06:00
CRDT- 2014/08/28 06:00
PHST- 2014/05/18 00:00 [received]
PHST- 2014/07/30 00:00 [accepted]
PHST- 2014/08/28 06:00 [entrez]
PHST- 2014/08/28 06:00 [pubmed]
PHST- 2015/12/17 06:00 [medline]
AID - 10.1007/s00464-014-3794-1 [doi]
PST - ppublish
SO  - Surg Endosc. 2015 May;29(5):1018-23. doi: 10.1007/s00464-014-3794-1. Epub 2014 
      Aug 27.