Prevalence of early marginal ulcer in sleeve to bypass conversions: an analysis of the 2020–2022 MBSAQIP

Authors

• Jake E. Doiron, LSU Health Sciences Center - New OrleansFollow
• Florina Corpodean, LSU Health Sciences Center - New OrleansFollow
• Michael Kachmar, LSU Health Sciences Center - New OrleansFollow
• Denise M. Danos, LSU Health Sciences Center - New OrleansFollow
• Michael W. Cook, LSU Health Sciences Center - New OrleansFollow
• Philip R. Schauer, LSU Health Sciences Center - New OrleansFollow
• Vance L. Albaugh, LSU Health Sciences Center - New OrleansFollow

Document Type

Article

Publication Date

2-7-2026

Publication Title

Surgery for Obesity and Related Diseases

Abstract

Background: Early marginal ulceration (MU) within 30 days after operation is uncommon after Roux-en-Y gastric bypass (RYGB), yet recent evidence indicates that these rates may be higher than initially thought. We hypothesized that the incidence of early MU would be higher in patients undergoing sleeve gastrectomy-RYGB (SG-RYGB) conversion compared with primary RYGB (p-RYGB). Setting: National quality improvement data from Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program (MBSAQIP)–accredited sites in the United States, 2020–2022. Methods: Examination of 610,529 records from the 2020–2022 MBSAQIP data sets noted 136,392 RYGB cases, after exclusions for pediatric cases, nonbinary gender, and records missing body mass index (BMI), operative time, age, and non–SG-RYGB conversions. We compared SG-RYGB and p-RYGB patient characteristics, surgical details, and postoperative outcomes, using rare event logistic regression to model early MU risk based on sleeve conversion status and additional risk factors. Results: Early MU developed in .2% (337 of 136,392) of p-RYGB cases and .4% (109 of 26,333) of SG-RYGB cases (P < .0001). SG-RYGB conversion was a significant predictor of early MU in a multivariable model (odds ratio: 1.42, 95% confidence interval: 1.10–1.84, P = .0069), along with factors such as Black race, BMI < 30, chronic obstructive pulmonary disease, prior cardiac catheterization, history of deep vein thrombosis, and active immunosuppression. Conclusions: Early MU remains a rare event after RYGB. Patients undergoing SG-RYGB face a 42% greater risk of developing early MU compared with those receiving p-RYGB, indicating the necessity for enhanced MU prevention measures in this demographic.

First Page

545

Last Page

553

PubMed ID

41791958

Volume

22

Issue

5

Rights

© 2026 American Society for Metabolic and Bariatric Surgery

Recommended Citation

Doiron, Jake E.; Corpodean, Florina; Kachmar, Michael; Danos, Denise M.; Cook, Michael W.; Schauer, Philip R.; and Albaugh, Vance L., "Prevalence of early marginal ulcer in sleeve to bypass conversions: an analysis of the 2020–2022 MBSAQIP" (2026). School of Medicine Faculty Publications. 4488.
https://digitalscholar.lsuhsc.edu/som_facpubs/4488
10.1016/j.soard.2026.02.004