• Skip to main content
  • Skip to header right navigation
  • Skip to site footer

Log in
  • Search
    • Search All SAGES Content
    • Search SAGES Guidelines
    • Search the Video Library
    • Search the Image Library
    • Search the Abstracts Archive
www.sages.org

SAGES

Reimagining surgical care for a healthier world

  • Home
    • Search
    • SAGES Home
    • SAGES Foundation Home
  • About
    • Awards
    • Who Is SAGES?
    • Leadership
    • Our Mission
    • Advocacy
    • Committees
      • SAGES Board of Governors
      • Officers and Representatives of the Society
      • Committee Chairs and Co-Chairs
      • Committee Rosters
      • SAGES Past Presidents
  • Meetings
    • SAGES NBT Innovation Weekend
    • SAGES Annual Meeting
      • 2026 Scientific Session Call for Abstracts
      • 2026 Emerging Technology Call for Abstracts
    • CME Claim Form
    • SAGES Past, Present, Future, and Related Meeting Information
    • SAGES Related Meetings & Events Calendar
  • Join SAGES!
    • Membership Application
    • Membership Benefits
    • Membership Types
      • Requirements and Applications for Active Membership in SAGES
      • Requirements and Applications for Affiliate Membership in SAGES
      • Requirements and Applications for Associate Active Membership in SAGES
      • Requirements and Applications for Candidate Membership in SAGES
      • Requirements and Applications for International Membership in SAGES
      • Requirements for Medical Student Membership
    • Member Spotlight
    • Give the Gift of SAGES Membership
  • Patients
    • Join the SAGES Patient Partner Network (PPN)
    • Patient Information Brochures
    • Healthy Sooner – Patient Information for Minimally Invasive Surgery
    • Choosing Wisely – An Initiative of the ABIM Foundation
    • All in the Recovery: Colorectal Cancer Alliance
    • Find A SAGES Surgeon
  • Publications
    • Clinical / Practice / Training Guidelines, Statements, and Standards of Practice
    • Sustainability in Surgical Practice
    • SAGES Stories Podcast
    • Patient Information Brochures
    • Patient Information From SAGES
    • TAVAC – Technology and Value Assessments
    • Surgical Endoscopy and Other Journal Information
    • SAGES Manuals
    • MesSAGES – The SAGES Newsletter
    • COVID-19 Archive
    • Troubleshooting Guides
  • Education
    • Wellness Resources – You Are Not Alone
    • Avoid Opiates After Surgery
    • SAGES Subscription Catalog
    • SAGES TV: Home of SAGES Surgical Videos
    • The SAGES Safe Cholecystectomy Program
    • Masters Program
    • Resident and Fellow Opportunities
      • MIS Fellows Course
      • SAGES Robotics Residents and Fellows Courses
      • SAGES Free Resident Webinar Series
      • Fluorescence-Guided Surgery Course for Fellows
      • Fellows’ Career Development Course
    • SAGES S.M.A.R.T. Enhanced Recovery Program
    • SAGES @ Cine-Med Products
      • SAGES Top 21 Minimally Invasive Procedures Every Practicing Surgeon Should Know
      • SAGES Pearls Step-by-Step
      • SAGES Flexible Endoscopy 101
    • SAGES OR SAFETY Video Activity
  • Opportunities
    • Fellowship Recognition Opportunities
    • SAGES Advanced Flexible Endoscopy Area of Concentrated Training (ACT) SEAL
    • Multi-Society Foregut Fellowship Certification
    • Research Opportunities
    • FLS
    • FES
    • FUSE
    • Jobs Board
    • SAGES Go Global: Global Affairs and Humanitarian Efforts
  • OWLS/FLS
You are here: Home / Abstracts / VATS vagotomy for persistent GJ ulcer after GBP: A single institution experience

VATS vagotomy for persistent GJ ulcer after GBP: A single institution experience

Tiffany Tanner, MD, Lora Melman, MD, Erika Leung, John Price, MD, Brent Sorenson, MD. Saint Luke’s Hospital

INTRODUCTION: Marginal ulcer is a potentially serious complication after gastric bypass surgery, occurring in 5-7% of patients. Many reports in the literature describe revisional transabdominal gastrojejunostomy for ulcers that are refractory to medical management, and only one study to date (Hunter, et al. Am Surg 2012 Jun;78(6):663-8) describes transthoracic vagotomy as an alternative approach, claiming 80% effectiveness for treating persistent GJ ulcers. The purpose of our study was to examine the outcomes of patients at our institution diagnosed with medically refractory GJ ulceration, who subsequently underwent vagotomy via videoscopic-assisted thoracoscopic surgery (VATS) approach.

METHODS AND PROCEDURES: Four patients were identified retrospectively between two practicing bariatric surgeons; all who underwent laparoscopic gastric bypass at an MBSAQIP-accredited Comprehensive Center between 2008-2011. After de-identification, data was collected with regard to pre-bypass demographics (sex, age, BMI), time interval between gastric bypass and ulcer diagnosis, length of medical management trial, and documentation of healed ulcer after vagotomy. All vagotomies were performed via VATS approach.

RESULTS: Of the four patients, 3 (75%) were female and 1 (25%) was male. Average age was 59 (range 51-66 years) and average BMI was 45.3 (range 40.7-48.8). Patients developed marginal ulcer at an average of 2.7 years post-laparoscopic roux y gastric bypass (range 1.6-4 years). Medical management was prescribed for an average of 3.2 months (range 1-6 months), consisting of twice-daily proton-pump inhibitors and carafate. One patient was diagnosed with metastatic cholangiocarcinoma after vagotomy and subsequently lost to follow up. The remaining three patients had complete ulcer healing as documented by upper endoscopy at an average of 2.3 months (range 1-4 months) post-vagotomy.

CONCLUSIONS: VATS vagotomy was extremely effective in achieving complete ulcer healing of medically refractory marginal ulcers post-gastric bypass. Although our study is limited by a small number of patients, it shows a strong trend in favor of VATS vagotomy as a reasonable alternative surgical approach versus transabdominal vagotomy and revision of gastrojejunostomy.

163

Share this:

  • Click to share on X (Opens in new window) X
  • Click to share on Facebook (Opens in new window) Facebook
  • Click to share on LinkedIn (Opens in new window) LinkedIn
  • Click to share on Pinterest (Opens in new window) Pinterest
  • Click to share on WhatsApp (Opens in new window) WhatsApp
  • Click to share on Reddit (Opens in new window) Reddit
  • Click to share on Pocket (Opens in new window) Pocket
  • Click to share on Mastodon (Opens in new window) Mastodon
  • Click to share on Threads (Opens in new window) Threads
  • Click to share on Bluesky (Opens in new window) Bluesky

Related


sages_adbutler_leaderboard

Hours & Info

11300 West Olympic Blvd, Suite 600
Los Angeles, CA 90064

1-310-437-0544

[email protected]

Monday – Friday
8am to 5pm Pacific Time

Find Us Around the Web!

  • Bluesky
  • X
  • Instagram
  • Facebook
  • YouTube

Copyright © 2025 · SAGES · All Rights Reserved

Important Links

Healthy Sooner: Patient Information

SAGES Guidelines, Statements, & Standards of Practice

SAGES Manuals