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Obesity Surgery

, Volume 19, Issue 6, pp 802–805 | Cite as

Pancreaticoduodenectomy after a Roux-En-Y Gastric Bypass

  • Amit S Khithani
  • David E Curtis
  • Christos Galanopoulos
  • Dhiresh Rohan JeyarajahEmail author
Modern Surgery: Technical Innovation

Abstract

Background

The surgical management of periampullary lesions, status post-Roux-en-Y gastric bypass procedure (RYGBP), poses a challenge. The strategy should focus on managing the gastric remnant.

Methods

We propose a technique of managing the gastric remnant while doing a pancreaticoduodenectomy (PD) in a patient with a previous RYGBP. From September 2005 to June 2008, two patients with a previous RYGBP underwent PD with a modified technique. The records were reviewed with respect to preoperative, intraoperative, and postoperative data.

Results

Both patients were operated for a carcinoma of the head of pancreas. Neither patient underwent a preoperative endoscopic ultrasound. The operating times were 315 and 218 min. There was no mortality or morbidity seen. Neither patient was re-operated. The mean length of stay was 6 days.

Conclusions

The technique suggests an approach of managing the gastric remnant and preventing delayed gastric emptying which resulted in a decreased length of hospital stay.

Keywords

Pancreaticoduodenectomy Periampullary cancer Roux-en-Y gastric bypass 

References

  1. 1.
    Galanopoulos CA, Jeyarajah DR. The Whip–Stow procedure: an innovative modification to the Whipple Procedure. Abstract presented at the Annual meeting of the American Hepato Pancreato Biliary Association (2008).Google Scholar
  2. 2.
    Nguyen NT, Tran CL, Gelfand DV, et al. Laparoscopic and thoracoscopic Ivor Lewis esophagectomy after Roux-en-Y gastric bypass. Ann Thorac Surg 2006;82(5):1910–3.CrossRefGoogle Scholar
  3. 3.
    Martinez J, Guerrero L, Byers P, et al. Endoscopic retrograde cholangiopancreatography and gastroduodenoscopy after Roux-en-Y gastric bypass. Surg Endosc 2006;20(10):1548–50.CrossRefGoogle Scholar
  4. 4.
    Traverso LW, Shinchi H, Low DE. Useful benchmarks to evaluate outcomes after esophagectomy and pancreaticoduodenectomy. Am J Surg 2004;187(5):604–8.CrossRefGoogle Scholar
  5. 5.
    Cameron JL, Riall TS, Coleman J, Belcher KA, et al. One thousand consecutive pancreaticoduodenectomies. Ann Surg 2006;244(1):10–5.CrossRefGoogle Scholar

Copyright information

© Springer Science + Business Media, LLC 2008

Authors and Affiliations

  • Amit S Khithani
    • 1
  • David E Curtis
    • 1
  • Christos Galanopoulos
    • 1
  • Dhiresh Rohan Jeyarajah
    • 1
    Email author
  1. 1.Methodist Dallas Medical CenterDallasUSA

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