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



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.


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.


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.


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


Pancreaticoduodenectomy Periampullary cancer Roux-en-Y gastric bypass 


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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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