Springer Nature is making SARS-CoV-2 and COVID-19 research free. View research | View latest news | Sign up for updates

Controversy Surrounding ‘Mini’ Gastric Bypass


Mini gastric bypass is a modification of Mason loop gastric bypass with a longer lesser curvature-based pouch. Though it has been around for more than 15 years, its uptake by the bariatric community has been relatively slow, and the procedure has been mired in controversy right from its early days. Lately, there seems to be a surge in the interest in this procedure, and there is now published experience with more than 5,000 procedures globally. This review examines the major controversial aspects of this procedure against the available scientific literature. Surgeons performing this procedure need to be aware of these controversies and counsel their patients appropriately.

This is a preview of subscription content, log in to check access.

Fig. 1



Mini gastric bypass


Roux-en-Y gastric bypass


Preferred Reporting Items for Systematic Reviews and Meta-Analyses


Laparoscopic Roux-en-Y gastric bypass


Laparoscopic mini gastric bypass


Gastro-oesophageal reflux disease


  1. 1.

    Mason EE, Ito C. Gastric bypass in obesity. Surg Clin North Am. 1967;47:1345–52.

  2. 2.

    Rutledge R. The mini-gastric bypass: experience with the first 1274 cases. Obes Surg. 2001;11(3):276–80.

  3. 3.

    Fisher BL, Buchwald H, Clark W, et al. Mini-gastric bypass controversy. Obes Surg. 2001;11(6):773–7.

  4. 4.

    Olchowski S, Timms MR, O’Brien P, et al. More on mini gastric bypass. Obes Surg. 2001;11(4):532.

  5. 5.

    Johnson WH, Fernanadez AZ, Farrell TM, et al. Surgical revision of loop (“mini”) gastric bypass procedure: multicenter review of complications and conversions to Roux-en-Y gastric bypass. Surg Obes Relat Dis. 2007;3(1):37–41.

  6. 6.

    Collins BJ, Miyashita T, Schweitzer M, et al. Gastric bypass. Why Roux-en-Y? A review of experimental data. Arch Surg. 2007;142(10):1000–3.

  7. 7.

    McCarthy HB, Rucker RD, Chan EK, et al. Gastritis after gastric bypass surgery. Surgery. 1985;98:68–71.

  8. 8.

    Rutledge R, Walsh TR. Continued excellent results with the mini-gastric bypass: six-year study in 2,410 patients. Obes Surg. 2005;15(9):1304–8.

  9. 9.

    Noun R, Skaff J, Riachi E, et al. One thousand consecutive mini-gastric bypass: short- and long-term outcome. Obes Surg. 2012;22(5):697–703.

  10. 10.

    Peraglie C. Laparoscopic mini-gastric bypass (LMGB) in the super-super obese: outcomes in 16 patients. Obes Surg. 2008;18(9):1126–9.

  11. 11.

    Chakhtoura G, Zinzindohoué F, Ghanem Y, et al. Primary results of laparoscopic mini-gastric bypass in a French obesity-surgery specialized university hospital. Obes Surg. 2008;18(9):1130–3.

  12. 12.

    Piazza L, Ferrara F, Leanza S, et al. A laparoscopic mini-gastric bypass: short-term single-institute experience. Updates Surg. 2011;63(4):239–42.

  13. 13.

    Carbajo M, García-Caballero M, Toledano M, et al. One-anastomosis gastric bypass by laparoscopy: results of the first 209 patients. Obes Surg. 2005;15(3):398–404.

  14. 14.

    García-Caballero M, Valle M, Martínez-Moreno JM, et al. Resolution of diabetes mellitus and metabolic syndrome in normal weight 24–29 BMI patients with one anastomosis gastric bypass. Nutr Hosp. 2012;27(2):623–31.

  15. 15.

    Kim Z, Hur KY. Laparoscopic mini-gastric bypass for type 2 diabetes: the preliminary report. World J Surg. 2011;35(3):631–6.

  16. 16.

    Lee WJ, Ser KH, Lee YC, et al. Laparoscopic Roux-en-Y vs. mini-gastric bypass for the treatment of morbid obesity: a 10-year experience. Obes Surg. 2012;22(12):1827–34.

  17. 17.

    Sinar DR, Flickinger EG, Park HK, et al. Retrograde endoscopy of the bypassed stomach segment after gastric bypass surgery: unexpected lesions. South Med J. 1985;78(3):255–8.

  18. 18.

    Byrne JP, Romagnoli R, Bechi P, et al. Duodenogastric reflux of bile in health: the normal range. Physiol Meas. 1999;20(2):149–58.

  19. 19.

    Fuchs KH, Maroske J, Fein M, et al. Variability in the composition of physiologic duodenogastric reflux. J Gastrointest Surg. 1999;3(4):389–95. discussion 395–6.

  20. 20.

    Fiorucci S, Distrutti E, Di Matteo F, et al. Circadian variations in gastric acid and pepsin secretion and intragastric bile acid in patients with reflux esophagitis and in healthy controls. Am J Gastroenterol. 1995;90(2):270–6.

  21. 21.

    Zhang Y, Yang X, Gu W, et al. Histological features of the gastric mucosa in children with primary bile reflux gastritis. World J Surg Oncol. 2012;10:27.

  22. 22.

    Matsuhisa T, Arakawa T, Watanabe T, et al. Relation between bile acid reflux into the stomach and the risk of atrophic gastritis and intestinal metaplasia: a multicenter study of 2283 cases. Dig Endosc. 2013;25(5):519–25. doi:10.1111/den.12030.

  23. 23.

    Lorusso D, Misciagna G, Mangini V, et al. Duodenogastric reflux of bile acids, gastrin and parietal cells, and gastric acid secretion before and 6 months after cholecystectomy. Am J Surg. 1990;159(6):575–8.

  24. 24.

    Kunsch S, Neesse A, Huth J, et al. Increased duodeno-gastro-esophageal reflux (DGER) in symptomatic GERD patients with a history of cholecystectomy. Z Gastroenterol. 2009;47(8):744–8.

  25. 25.

    Cabrol J, Navarro X, Simo-Deu J, et al. Evaluation of duodenogastric reflux in gallstone disease before and after simple cholecystectomy. Am J Surg. 1990;160(3):283–6.

  26. 26.

    Atak I, Ozdil K, Yücel M, et al. The effect of laparoscopic cholecystectomy on the development of alkaline reflux gastritis and intestinal metaplasia. Hepatogastroenterology. 2012;59(113):59–61.

  27. 27.

    Lee Y, Tokunaga A, Tajiri T, et al. Inflammation of the gastric remnant after gastrectomy: mucosal erythema is associated with bile reflux and inflammatory cellular infiltration is associated with Helicobacter pylori infection. J Gastroenterol. 2004;39(6):520–6.

  28. 28.

    Lorusso D, Linsalata M, Pezzolla F, et al. Duodenogastric reflux and gastric mucosal polyamines in the non-operated stomach and in the gastric remnant after Billroth II gastric resection. A role in gastric carcinogenesis? Anticancer Res. 2000;20(3B):2197–201.

  29. 29.

    Parrilla P, Lujan JA, Robles R, et al. Duodenogastric reflux quantification in peptic ulcer surgery: comparison between different surgical techniques. Surgery. 1993;113(1):43–7.

  30. 30.

    Bechi P, Balzi M, Becciolini A, et al. Gastric cell proliferation kinetics and bile reflux after partial gastrectomy. Am J Gastroenterol. 1991;86(10):1424–32.

  31. 31.

    Watson RG, Love AH. Intragastric bile acid concentrations are unrelated to symptoms of flatulent dyspepsia in patients with and without gallbladder disease and postcholecystectomy. Gut. 1987;28(2):131–6.

  32. 32.

    Collins BJ, Crothers G, McFarland RJ, et al. Bile acid concentrations in the gastric juice of patients with erosive oesophagitis. Gut. 1985;26(5):495–9.

  33. 33.

    Bost R, Hostein J, Valenti M, et al. Is there an abnormal fasting duodenogastric reflux in nonulcer dyspepsia? Dig Dis Sci. 1990;35(2):193–9.

  34. 34.

    Schindlbeck NE, Heinrich C, Stellaard F, et al. Healthy controls have as much bile reflux as gastric ulcer patients. Gut. 1987;28(12):1577–83.

  35. 35.

    Lee WJ, Yu PJ, Wang W, et al. Laparoscopic Roux-en-Y versus mini-gastric bypass for the treatment of morbid obesity: a prospective randomized controlled clinical trial. Ann Surg. 2005;242(1):20–8.

  36. 36.

    Sacks BC, Mattar SG, Qureshi FG, et al. Incidence of marginal ulcers and the use of absorbable anastomotic sutures in laparoscopic Roux-en-Y gastric bypass. Surg Obes Relat Dis. 2006;2(1):11–6.

  37. 37.

    Gumbs AA, Duffy AJ, Bell RL. Incidence and management of marginal ulceration after laparoscopic Roux-Y gastric bypass. Surg Obes Relat Dis. 2006;2(4):460–3.

  38. 38.

    Dallal RM, Bailey LA. Ulcer disease after gastric bypass surgery. Surg Obes Relat Dis. 2006;2(4):455–9.

  39. 39.

    McVay MA, Friedman KE, Applegate KL, et al. Patient predictors of follow-up care attendance in Roux-en-Y gastric bypass patients. Surg Obes Relat Dis. 2012. doi:10.1016/j.soard.2012.11.005.

  40. 40.

    Lara MD, Baker MT, Larson CJ, et al. Travel distance, age, and sex as factors in follow-up visit compliance in the post-gastric bypass population. Surg Obes Relat Dis. 2005;1(1):17–21.

  41. 41.

    Harper J, Madan AK, Ternovits CA, et al. What happens to patients who do not follow-up after bariatric surgery? Am Surg. 2007;73(2):181–4.

  42. 42.

    Shen R, Dugay G, Rajaram K, et al. Impact of patient follow-up on weight loss after bariatric surgery. Obes Surg. 2004;14(4):514–9.

  43. 43.

    McQuaid KR, Laine L, Fennerty MB, et al. Systematic review: the role of bile acids in the pathogenesis of gastro-oesophageal reflux disease and related neoplasia. Aliment Pharmacol Ther. 2011;34(2):146–65.

  44. 44.

    Nason KS, Farrow DC, Haigh G, et al. Gastric fluid bile concentrations and risk of Barrett’s esophagus. Interact Cardiovasc Thorac Surg. 2007;6(3):304–7.

  45. 45.

    Taha AS, Angerson WJ, Morran CG. Reflux and Barrett’s oesophagitis after gastric surgery—long-term follow-up and implications for the roles of gastric acid and bile in oesophagitis. Aliment Pharmacol Ther. 2003;17(4):547–52.

  46. 46.

    Parrilla P, Liron R, Martinez de Haro LF, et al. Gastric surgery does not increase the risk of developing Barrett's esophagus. Am J Gastroenterol. 1997;92(6):960–3.

  47. 47.

    Avidan B, Sonnenberg A, Schnell TG, et al. Gastric surgery is not a risk for Barrett’s esophagus or esophageal adenocarcinoma. Gastroenterology. 2001;121(6):1281–5.

  48. 48.

    Akiyama T, Inamori M, Akimoto K, et al. Gastric surgery is not a risk factor for erosive esophagitis or Barrett’s esophagus. Scand J Gastroenterol. 2010;45(4):403–8.

  49. 49.

    Champion G, Richter JE, Vaezi MF, et al. Duodenogastroesophageal reflux: relationship to pH and importance in Barrett’s esophagus. Gastroenterology. 1994;107(3):747–54.

  50. 50.

    Caygill CP, Hill MJ, Kirkham JS, et al. Mortality from gastric cancer following gastric surgery for peptic ulcer. Lancet. 1986;1(8487):929–31.

  51. 51.

    Lundegårdh G, Adami HO, Helmick C, et al. Stomach cancer after partial gastrectomy for benign ulcer disease. N Engl J Med. 1988;319(4):195–200.

  52. 52.

    Fisher SG, Davis F, Nelson R, et al. A cohort study of stomach cancer risk in men after gastric surgery for benign disease. J Natl Cancer Inst. 1993;85(16):1303–10.

  53. 53.

    Tersmette AC, Goodman SN, Offerhaus GJ, et al. Multivariate analysis of the risk of stomach cancer after ulcer surgery in an Amsterdam cohort of postgastrectomy patients. Am J Epidemiol. 1991;134(1):14–21.

  54. 54.

    Domellöf L, Janunger KG. The risk for gastric carcinoma after partial gastrectomy. Am J Surg. 1977;134(5):581–4.

  55. 55.

    Ovaska JT, Havia TV, Kujari HP. Risk of gastric stump carcinoma after gastric resection for benign ulcer disease. Ann Chir Gynaecol. 1986;75(4):192–5.

  56. 56.

    Viste A, Bjørnestad E, Opheim P, et al. Risk of carcinoma following gastric operations for benign disease. A historical cohort study of 3470 patients. Lancet. 1986;2(8505):502–5.

  57. 57.

    Schafer LW, Larson DE, Melton 3rd LJ, et al. The risk of gastric carcinoma after surgical treatment for benign ulcer disease. A population-based study in Olmsted County, Minnesota. N Engl J Med. 1983;309(20):1210–3.

  58. 58.

    Fischer AB, Graem N, Jensen OM. Risk of gastric cancer after Billroth II resection for duodenal ulcer. Br J Surg. 1983;70(9):552–4.

  59. 59.

    Schnapka G, Hofstaedter F, Schwamberger K, et al. Gastric stump carcinoma following Billroth II resection for peptic ulcer disease. Comparison with cancer in non-operated stomach. Endoscopy. 1984;16(5):171–4.

  60. 60.

    Pointner R, Schwab G, Königsrainer A, et al. Gastric stump cancer: etiopathological and clinical aspects. Endoscopy. 1989;21(3):115–9.

  61. 61.

    Tokudome S, Kono S, Ikeda M, et al. A prospective study on primary gastric stump cancer following partial gastrectomy for benign gastroduodenal diseases. Cancer Res. 1984;44(5):2208–12.

  62. 62.

    Luukkonen P, Kalima T, Kivilaakso E. Decreased risk of gastric stump carcinoma after partial gastrectomy supplemented with bile diversion. Hepatogastroenterology. 1990;37 Suppl 2:171–3.

  63. 63.

    Kivilaakso E, Hakkiluoto A, Kalima TV, et al. Relative risk of stump cancer following partial gastrectomy. Br J Surg. 1977;64(5):336–8.

  64. 64.

    Lagergren J, Lindam A, Mason RM. Gastric stump cancer after distal gastrectomy for benign gastric ulcer in a population-based study. Int J Cancer. 2012;131(6):E1048–52.

  65. 65.

    La Vecchia C, Negri E, D’Avanzo B, et al. Partial gastrectomy and subsequent gastric cancer risk. J Epidemiol Community Health. 1992;46(1):12–4.

  66. 66.

    Lacaine F, Houry S, Huguier M. Stomach cancer after partial gastrectomy for benign ulcer disease. A critical analysis of epidemiological reports. Hepatogastroenterology. 1992;39(1):4–8.

  67. 67.

    Hansson LE, Nyrén O, Hsing AW, et al. The risk of stomach cancer in patients with gastric or duodenal ulcer disease. N Engl J Med. 1996;335(4):242–9.

  68. 68.

    Seoane A, Bessa X, Alameda F, et al. Role of Helicobacter pylori in stomach cancer after partial gastrectomy for benign ulcer disease. Rev Esp Enferm Dig. 2005;97(11):778–85.

  69. 69.

    Marshall BJ, Warren JR. Unidentified curved bacilli in the stomach of patients with gastritis and peptic ulceration. Lancet. 1984;1(8390):1311–5.

  70. 70.

    Marshall BJ, Warren JR, Francis GJ, et al. Rapid urease test in the management of Campylobacter pyloridis-associated gastritis. Am J Gastroenterol. 1987;82(3):200–10.

  71. 71.

    Marshall BJ, Goodwin CS, Warren JR, et al. Prospective double-blind trial of duodenal ulcer relapse after eradication of Campylobacter pylori. Lancet. 1988;2(8626–8627):1437–42.

  72. 72.

    Tersmette AC, Offerhaus GJ, Tersmette KW, et al. Meta-analysis of the risk of gastric stump cancer: detection of high risk patient subsets for stomach cancer after remote partial gastrectomy for benign conditions. Cancer Res. 1990;50(20):6486–9.

  73. 73.

    Bahmanyar S, Ye W, Dickman PW, et al. Long-term risk of gastric cancer by subsite in operated and unoperated patients hospitalized for peptic ulcer. Am J Gastroenterol. 2007;102(6):1185–91.

  74. 74.

    Caygill CP, Knowles RL, Hall R. Increased risk of cancer mortality after vagotomy for peptic ulcer: a preliminary analysis. Eur J Cancer Prev. 1991;1(1):35–7.

  75. 75.

    Lundegårdh G, Adami HO, Helmick C, et al. Risk of cancer following partial gastrectomy for benign ulcer disease. Br J Surg. 1994;81(8):1164–7.

  76. 76.

    Leivonen M, Nordling S, Haglund C. Does Helicobacter pylori in the gastric stump increase the cancer risk after certain reconstruction types? Anticancer Res. 1997;17(5B):3893–6.

  77. 77.

    Nagahata Y, Kawakita N, Azumi Y, et al. Etiological involvement of Helicobacter pylori in “reflux” gastritis after gastrectomy. Am J Gastroenterol. 1996;91(10):2130–4.

  78. 78.

    Li XB, Lu H, Chen HM, et al. Role of bile reflux and Helicobacter pylori infection on inflammation of gastric remnant after distal gastrectomy. J Dig Dis. 2008;9(4):208–12.

  79. 79.

    Nakagawara H, Miwa K, Nakamura S, et al. Duodenogastric reflux sustains Helicobacter pylori infection in the gastric stump. Scand J Gastroenterol. 2003;38(9):931–7.

  80. 80.

    Bair MJ, Wu MS, Chang WH, et al. Spontaneous clearance of Helicobacter pylori colonization in patients with partial gastrectomy: correlates with operative procedures and duration after operation. J Formos Med Assoc. 2009;108(1):13–9.

  81. 81.

    Tomtitchong P, Onda M, Matsukura N, et al. Helicobacter pylori infection in the remnant stomach after gastrectomy: with special reference to the difference between Billroth I and II anastomoses. J Clin Gastroenterol. 1998;27 Suppl 1:S154–8.

  82. 82.

    Sitarz R, Maciejewski R, Polkowski WP, et al. Gastroenterostoma after Billroth antrectomy as a premalignant condition. World J Gastroenterol. 2012;18(25):3201–6.

  83. 83.

    Nunobe S, Ohyama S, Miyata S, et al. Incidence of gastric cancer in the remnant stomach after proximal gastrectomy. Hepatogastroenterology. 2008;55(86–87):1855–8.

  84. 84.

    Tersmette AC, Giardiello FM, Offerhaus GJ, et al. Geographical variance in the risk of gastric stump cancer: no increased risk in Japan? Jpn J Cancer Res. 1991;82(3):266–72.

  85. 85.

    Lee SW, Tanigawa N, Nomura E, et al. Benefits of intracorporeal gastrointestinal anastomosis following laparoscopic distal gastrectomy. World J Surg Oncol. 2012;10:267.

  86. 86.

    Du J, Shuang J, Li J, et al. Totally laparoscopic Billroth II gastrectomy with a novel, safe, simple, and time-saving anastomosis by only stapling devices. J Gastrointest Surg. 2012;16(4):738–43.

  87. 87.

    Lee J, Kim D, Kim W. Comparison of laparoscopy-assisted and totally laparoscopic Billroth-II distal gastrectomy for gastric cancer. J Korean Surg Soc. 2012;82(3):135–42.

  88. 88.

    Oh SJ, Hong JJ, Oh CA, et al. Stapling technique for performing Billroth II anastomosis after distal gastrectomy. J Gastrointest Surg. 2011;15(7):1244–6.

  89. 89.

    Kang KC, Cho GS, Han SU, et al. Korean Laparoscopic Gastrointestinal Surgery Study (KLASS) Group. Comparison of Billroth I and Billroth II reconstructions after laparoscopy-assisted distal gastrectomy: a retrospective analysis of large-scale multicenter results from Korea. Surg Endosc. 2011;25(6):1953–61.

  90. 90.

    Sah BK, Chen MM, Yan M, et al. Gastric cancer surgery: Billroth I or Billroth II for distal gastrectomy? BMC Cancer. 2009;9:428.

  91. 91.

    Lagergren J, Lindam A. The risk of oesophageal adenocarcinoma after gastrectomy for peptic ulcer disease. Eur J Cancer. 2012;48(5):749–52.

  92. 92.

    Birgisson S, Rice TW, Easley KA, et al. The lack of association between adenocarcinoma of the esophagus and gastric surgery: a retrospective study. Am J Gastroenterol. 1997;92(2):216–21.

  93. 93.

    Alexandrou A, Davis PA, Law S, et al. Esophageal cancer in patients with a history of distal gastrectomy. Arch Surg. 2002;137(11):1238–42.

  94. 94.

    Hashimoto N, Inayama M, Fujishima M, et al. Esophageal cancer after distal gastrectomy. Dis Esophagus. 2006;19(5):346–9.

  95. 95.

    Lorusso D, Pezzolla F, Linsalata M, et al. Duodenogastric reflux and gastric mucosal cell proliferation after cholecystectomy or Billroth II gastric resection. Gastroenterol Clin Biol. 1994;18(11):927–31.

  96. 96.

    Wilson P, Jamieson JR, Hinder RA, et al. Pathologic duodenogastric reflux associated with persistence of symptoms after cholecystectomy. Surgery. 1995;117(4):421–8.

  97. 97.

    Fein M, Bueter M, Sailer M, et al. Effect of cholecystectomy on gastric and esophageal bile reflux in patients with upper gastrointestinal symptoms. Dig Dis Sci. 2008;53(5):1186–91.

  98. 98.

    Fall K, Ye W, Nyrén O. Risk for gastric cancer after cholecystectomy. Am J Gastroenterol. 2007;102(6):1180–4.

  99. 99.

    Freedman J, Lagergren J, Bergström R, et al. Cholecystectomy, peptic ulcer disease and the risk of adenocarcinoma of the oesophagus and gastric cardia. Br J Surg. 2000;87(8):1087–93.

  100. 100.

    Ge Z, Zhao C, Wang Y, et al. Cholecystectomy and the risk of esophageal and gastric cancer. Saudi Med J. 2012;33(10):1073–9.

  101. 101.

    Gustavsson S, Adami HO, Meirik O, et al. Cholecystectomy as a risk factor for gastric cancer. A cohort study. Dig Dis Sci. 1984;29(2):116–20.

  102. 102.

    Freedman J, Ye W, Näslund E, et al. Association between cholecystectomy and adenocarcinoma of the esophagus. Gastroenterology. 2001;121(3):548–53.

  103. 103.

    Lagergren J, Mattsson F. Cholecystectomy as a risk factor for oesophageal adenocarcinoma. Br J Surg. 2011;98(8):1133–7.

  104. 104.

    Scozzari G, Trapani R, Toppino M, et al. Esophagogastric cancer after bariatric surgery: systematic review of the literature. Surg Obes Relat Dis. 2013;9(1):133–42.

  105. 105.

    Inoue H, Rubino F, Shimada Y, et al. Risk of gastric cancer after Roux-en-Y gastric bypass. Arch Surg. 2007;142(10):947–53.

  106. 106.

    Rutledge R. Hospitalization before and after mini-gastric bypass surgery. Int J Surg. 2007;5(1):35–40.

  107. 107.

    Wang W, Wei PL, Lee YC, et al. Short-term results of laparoscopic mini-gastric bypass. Obes Surg. 2005;15(5):648–54.

  108. 108.

    Noun R, Zeidan S. Laparoscopic mini-gastric bypass: an effective option for the treatment of morbid obesity. J Chir (Paris). 2007;144(4):301–4 [Article in French].

  109. 109.

    Chevallier JM, Chakhtoura G, Zinzindohoué F. [Laparoscopic mini-gastric bypass]. J Chir (Paris). 2009;146(1):60–4.

  110. 110.

    Copăescu C, Munteanu R, Prala N, et al. Laparoscopic mini gastric bypass for the treatment of morbid obesity. Initial experience. Chirurgia (Bucur). 2004;99(6):529–39 [Article in Romanian].

  111. 111.

    Hu XG, Zheng CZ, Ji XR, et al. Short-term outcome of laparoscopic gastric bypass and minigastric bypass on obesity patients with type 2 diabetes mellitus. Zhonghua Wei Chang Wai Ke Za Zhi. 2009;12(6):554–7 [Article in Chinese].

  112. 112.

    Guo X, Yin K, Zhuo GZ, et al. Efficacy comparison between 2 methods of laparoscopic gastric bypass surgery in the treatment of type 2 diabetes mellitus]. Zhonghua Wei Chang Wai Ke Za Zhi. 2012;15(11):1125–8 [Article in Chinese].

  113. 113.

    Lee WJ, Lee YC, Ser KH, et al. Revisional surgery for laparoscopic minigastric bypass. Surg Obes Relat Dis. 2011;7(4):486–91.

  114. 114.

    Lee WJ, Wang W, Lee YC, et al. Effect of laparoscopic mini-gastric bypass for type 2 diabetes mellitus: comparison of BMI > 35 and <35 kg/m2. J Gastrointest Surg. 2008;12(5):945–52.

  115. 115.

    Lee WJ, Wang W, Lee YC, et al. Laparoscopic mini-gastric bypass: experience with tailored bypass limb according to body weight. Obes Surg. 2008;18(3):294–9.

  116. 116.

    Noun R, Riachi E, Zeidan S, et al. Mini-gastric bypass by mini-laparotomy: a cost-effective alternative in the laparoscopic era. Obes Surg. 2007;17(11):1482–6.

  117. 117.

    Mahawar KK, Jennings N, Brown J, Gupta A, Balupuri S, Small PK. “Mini” gastric bypass: systematic review of a controversial procedure. Obes Surg. 2003.

  118. 118.

    Kuzmak LI, Yap IS, McGuire L, et al. Surgery for morbid obesity. Using an inflatable gastric band. AORN J. 1990;51(5):1307–24. Erratum in: AORN J 1990; 51(6): 1573.

  119. 119.

    de Csepel J, Burpee S, Jossart G, et al. Laparoscopic biliopancreatic diversion with a duodenal switch for morbid obesity: a feasibility study in pigs. J Laparoendosc Adv Surg Tech A. 2001;11(2):79–83.

  120. 120.

    Milone L, Strong V, Gagner M. Laparoscopic sleeve gastrectomy is superior to endoscopic intragastric balloon as a first stage procedure for super-obese patients (BMI > or =50). Obes Surg. 2005;15(5):612–7.

  121. 121.

    Buchwald H, Oien DM. Metabolic/bariatric surgery worldwide 2008. Obes Surg. 2009;19(12):1605–11.

  122. 122.

    Lomanto D, Lee WJ, Goel R, et al. Bariatric surgery in Asia in the last 5 years (2005–2009). Obes Surg. 2012;22(3):502–6. Erratum in: Obes Surg. 2012 Feb;22(2):345. Fah, Chin Kin [corrected to Chin, Kin-Fah].

  123. 123.

    Himpens J, Cadière GB, Bazi M, et al. Long-term outcomes of laparoscopic adjustable gastric banding. Arch Surg. 2011;146(7):802–7.

  124. 124.

    Stroh C, Hohmann U, Schramm H, et al. Fourteen-year long-term results after gastric banding. J Obes. 2011;2011:128451.

  125. 125.

    Weiner RA, Theodoridou S, Weiner S. Failure of laparoscopic sleeve gastrectomy—further procedure? Obes Facts. 2011;4 Suppl 1:42–6.

  126. 126.

    Gautier T, Sarcher T, Contival N, et al. Indications and mid-term results of conversion from sleeve gastrectomy to Roux-en-Y gastric bypass. Obes Surg. 2013;23(2):212–5.

  127. 127.

    Chiu S, Birch DW, Shi X, et al. Effect of sleeve gastrectomy on gastroesophageal reflux disease: a systematic review. Surg Obes Relat Dis. 2011;7(4):510–5.

  128. 128.

    Azagury DE, Varban O, Tavakkolizadeh A, et al. Does laparoscopic gastric banding create hiatal hernias? Surg Obes Relat Dis. 2013;9(1):48–52.

Download references

Conflict of interest


Author information

Correspondence to Kamal K. Mahawar.

Rights and permissions

Reprints and Permissions

About this article

Cite this article

Mahawar, K.K., Carr, W.R.J., Balupuri, S. et al. Controversy Surrounding ‘Mini’ Gastric Bypass. OBES SURG 24, 324–333 (2014).

Download citation


  • Bariatric surgery
  • Mini gastric bypass
  • Omega loop gastric bypass
  • Obesity
  • Obesity surgery
  • Biliary reflux
  • Cancer