Management of Acute Gastric Remnant Complications After Roux-en-Y Gastric Bypass: a Single-Center Case Series

Obes Surg. 2020 Jul;30(7):2637-2641. doi: 10.1007/s11695-020-04537-w.

Abstract

Purpose: Roux-en-Y gastric bypass is a common bariatric procedure. Its configuration creates an excluded gastric remnant, which is subject to potential acute complications such as bleeding, perforation, and necrosis.

Material and methods: A retrospective analysis of a prospective database including all patients presenting between 2007 and 2019 to our institution with acute gastric remnant complications after RYGB was performed.

Results: Seven patients were included, including 3 hemorrhages, two of which were treated with double-balloon enteroscopy, as well as 3 perforations and 1 necrosis, all of which required emergent surgery. Overall gastric remnant complication rate was 0.3% in this series.

Conclusion: Acute gastric remnant complications after RYGB are infrequent, but their diagnosis and management can be challenging. Double-balloon enteroscopy has diagnostic and therapeutic value for selected patients. Emergent surgery remains the standard of care for unstable patients and should not be delayed.

Keywords: Bariatric surgery; Gastric remnant; Roux-en-Y gastric bypass.

MeSH terms

  • Gastric Bypass* / adverse effects
  • Gastric Stump* / surgery
  • Humans
  • Laparoscopy*
  • Obesity, Morbid* / surgery
  • Retrospective Studies