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

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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.

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Author information

Authors and Affiliations

  1. Department of Surgery, Division of Minimally Invasive and Elective General Surgery, McGovern Medical School, University of Texas Health Science Center at Houston, 6431 Fannin Street, MSB 4.156, Houston, TX, 77030, USA

    Pouya Iranmanesh, Naveen V. Manisundaran, Kulvinder S. Bajwa, Nirav C. Thosani, Melissa M. Felinski, Erik B. Wilson & Shinil K. Shah

  2. Michael E. DeBakey Institute for Comparative Cardiovascular Science and Biomedical Devices, Texas A&M University, College Station, TX, USA

    Shinil K. Shah

Authors
  1. Pouya Iranmanesh
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  2. Naveen V. Manisundaran
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  3. Kulvinder S. Bajwa
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  4. Nirav C. Thosani
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  5. Melissa M. Felinski
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  6. Erik B. Wilson
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  7. Shinil K. Shah
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Corresponding author

Correspondence to Shinil K. Shah.

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Conflict of Interest

Pouya Iranmanesh, MD – no conflict of interest.

Naveen V. Manisundaran, MD – no conflict of interest.

Kulvinder S. Bajwa, MD – no conflict of interest.

Nirav C. Thosani, MD – no conflict of interest.

Melissa M. Felinski, DO – no conflict of interest.

Erik B. Wilson, MD – Teaching honoraria from Intuitive Surgical, Olympus, Gore, Apollo, and Ethicon.

Shinil K. Shah, DO – Honoraria from Gore and C-SATS; Research grant funding from Medigus and Intuitive Surgical (these grants were not used in any way during this study).

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.

Statement of Informed Consent

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

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Iranmanesh, P., Manisundaran, N.V., Bajwa, K.S. et al. Management of Acute Gastric Remnant Complications After Roux-en-Y Gastric Bypass: a Single-Center Case Series. OBES SURG 30, 2637–2641 (2020). https://doi.org/10.1007/s11695-020-04537-w

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  • DOI: https://doi.org/10.1007/s11695-020-04537-w

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