Advertisement

Obesity Surgery

, Volume 29, Issue 4, pp 1429–1431 | Cite as

Laparoscopic Management of Dilatation of Excluded Stomach After Roux-en-Y Gastric Bypass

  • Letizia Zurli
  • Lionel Rebibo
  • Simon MsikaEmail author
Video Submission
  • 54 Downloads

Abstract

Introduction

Roux-en-Y gastric bypass (RYGB) is considered as the gold standard for surgical management of morbid obesity due to its good results on weight loss and correction of comorbidities related to obesity and its few complication rates. Here, we describe a present strategy for dealing with an unusual complication after RYGB, responsible for chronic pain, as a chronic dilatation of excluded stomach.

Methods

The video shows our laparoscopic treatment of an excluded gastric fundus dilatation. A 21-year-old woman with history of RYGB was admitted in our center for recurrent abdominal pain. Many consultations have been performed before for the same reason and without explanation for this chronic abdominal pain.

Results

We found that a dilatation of the excluded gastric fundus was responsible for recurrent abdominal pain and thus required revisional surgery. An abdominal computed tomography with oral contrast study showed an atypical dilatation of the excluded stomach without gastro-gastric fistula or others abnormal findings. Intra-operative exploration then revealed multiple adhesions. During surgery, released of the excluded stomach allow to confirm a dilatation of the excluded fundus due to error in stapling when performing the vertical part of the gastric pouch of the RYGB. We resected the excluded dilated gastric fundus. An uneventful post-operative course enabled rapid discharge (post-operative day 3).

Conclusion

Dilatation of the excluded gastric pouch due to staple line misfiring during RYGB is a rare complication and can explain chronic abdominal pain. Laparoscopy can be useful to confirm the diagnosis and allow treatment using gastric resection in our case.

Keywords

Roux-en-Y gastric bypass Excluded stomach Post-operative complications 

Abbreviations

SG

sleeve gastrectomy

RYGB

Roux en Y gastric bypass

Notes

Compliance with Ethical Standards

Conflict of Interest

The authors declare that they have no conflict of interest.

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed Consent

Informed consent was obtained by all individual participants included in the study.

Supplementary material

11695_2018_3690_MOESM1_ESM.mp4 (238.7 mb)
ESM 1 (MP4 244,447 kb)

References

  1. 1.
    Javanainen M, Penttilä A, Mustonen H, et al. A retrospective 2-year follow-up of late complications treated surgically and endoscopically after laparoscopic Roux-en-Y gastric bypass (LRYGB) and laparoscopic sleeve gastrectomy (LSG) for morbid obesity. Obes Surg. 2018;28:1055–62.CrossRefGoogle Scholar
  2. 2.
    Zak Y, Petrusa E, Gee DW. Laparoscopic Roux-en-Y gastric bypass patients have an increased lifetime risk of repeat operations when compared to laparoscopic sleeve gastrectomy patients. Surg Endosc. 2016;30:1833–8.CrossRefGoogle Scholar
  3. 3.
    Young MT, Gebhart A, Phelan MJ, et al. Use and outcomes of laparoscopic sleeve gastrectomy vs laparoscopic gastric bypass: analysis of the American College of Surgeons NSQIP. J Am Coll Surg. 2015;220:880–5.CrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Department of Digestive, Esogastric and Bariatric SurgeryBichat-Claude Bernard University HospitalParisFrance
  2. 2.Service de Chirurgie Digestive, Œsogastrique et BariatiqueHôpital Bichat Claude BernardParisFrance

Personalised recommendations