Specialty Article: so You Think You Got a Bypass? A Case Series of Adventures in Bariatric Surgery

AbstractTo raise awareness for surgeons encountering bariatric patients with anatomy that deviates from the standard Roux-en-Y gastric bypass (RYGB). This is a single-institution retrospective case series over 12  years (2003–2014) involving patients who believed they received RYGBs, but actually did not. Data was obtained reviewing physician encounters, imaging, and operative reports. There were six cases with confusing clinical pictures, found to have aberrant RYGB anatomy: (1) gastric bypass with jejun o-jejunostomy only without gastrojejunostomy, (2) distal partial vertical gastrectomy without expected prosthetic band, (3) inverse vertical banded gastroplasty, (4) non-divided gastric bypass with no gastrojejunostomy, (5) 20-cm Roux limb, with gastro-gastric fistula, and (6) 200-cm bilio-pancreati c limb similar to the traditional Scopinaro procedure. There are cases of “Roux-en-Y gastric bypasses” that have no resemblance to the named procedure at all. Adjunctive upper gastrointestinal studies and upper endoscopies help surgeons make diagnoses that are incongruent with the surgical histo ry. It is important to keep in mind that there could be anatomic or surgical variations which were born out of necessity or based on other surgeons’ creativities.
Source: Obesity Surgery - Category: Surgery Source Type: research