Updates in Surgery

, Volume 70, Issue 1, pp 149–150 | Cite as

Intraoperative pouch stricture during laparoscopic one-anastomosis gastric bypass: case report, salvage description and follow-up

  • Stefano Cristiano
  • Domenico Ivan Fico
  • Salvatore Tolone
Letter to the Editor

Dear Editor,

We read with interest the paper by Godina et al. [1] dealing with a possible complication and its solution in a patient who underwent one-anastomosis-gastric bypass (OAGB). However, as for all surgical procedure, OAGB can be affected by intraoperative complication, that a surgeon should know, to avoid them and/or to treat them effectively.

We report a case of an intraoperative pouch stricture occurring during laparoscopic OAGB and its intraoperative management with a new salvage technique for stomach integrity.

Case presentation and management

A 47-year-old obese female (110 kg, BMI 49) with initial type 2 diabetes mellitus (T2DM, blood glucose 142 mg/dL, HbA1c 6.8 g/dL, managed with metformin 500 mg/bid) and obstructive sleep apnea syndrome (OSAS) underwent bariatric surgery. Pre-operative upper endoscopy and high-resolution manometry (HRM) were within normal limits; impedance-pH monitoring documented a presence of mild gastro-esophageal reflux, so OAGB was indicated.



Compliance with ethical standards

Conflict of interest

Authors declare no conflict of interest related to the subject of this study.

Research involving human participants and/or animals

All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (Institutional and National) and with the Helsinki Declaration of 1964 and later version.

Informed consent

For this type of study formal consent is not required.


  1. 1.
    Godina M, Nagliati C, Menegon P, Caruso V (2017) Emergency laparoscopic conversion from mini/one anastomosis gastric bypass to modified Roux-en-Y-gastric bypass due to acute bleeding from a recurrent marginal ulcer. Updates Surg. (Epub ahead of print) PubMedGoogle Scholar
  2. 2.
    Tolone S, Cristiano S, Savarino E et al (2016) Effects of omega-loop bypass on esophagogastric junction function. Surg Obes Relat Dis 12:62–69CrossRefPubMedGoogle Scholar
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    Haddad A, Tapazoglou N, Singh K, Averbach A (2012) Role of intraoperative esophagogastroenteroscopy in minimizing gastrojejunostomy-related morbidity: experience with 2,311 laparoscopic gastric bypasses with linear stapler anastomosis. Obes Surg 22:1928–1933CrossRefPubMedPubMedCentralGoogle Scholar
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    Ibele A, Garren M, Gould J (2010) Effect of circular staple line buttressing material on gastrojejunostomy failure in laparoscopic Roux-en-Y gastric bypass. Surg Obes Relat Dis 6:64–67CrossRefPubMedGoogle Scholar

Copyright information

© Italian Society of Surgery (SIC) 2017

Authors and Affiliations

  1. 1.Bariatric Surgery Unit“Trusso” ClinicOttavianoItaly
  2. 2.Division of General and Bariatric Surgery, Department of SurgeryUniversity of Campania “Luigi Vanvitelli”NaplesItaly

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