Intraoperative Finding of a Gastric Lymphoma during Gastric Bypass Surgery

Remnant Gastrectomy and Gastric Bypass: A Systematic Review of Indications and Outcomes of Resectional Gastric Bypass

BACKGROUND

In this systematic review, we aim to evaluate the reasons and outcomes behind remnant gastrectomy with or after gastric bypass procedures.

RESULTS

A total of 66 studies examining 1918 patients were included in this study with 70% of female predominance. Twenty studies reported RGB on 1751 patients and 46 studies reported remnant gastrectomy after gastric bypass in 167 patients. The most common etiology of RGB was related to the in situ remnant stomach neoplasia in 10 studies on 981 patients; mostly for preventive intentions in high prevalence areas. Remnant gastrectomy after gastric bypass was performed to treat a complication such as GGF, retrograde bile reflux gastritis, cancer mostly adenocarcinoma. Studies revealed that RGB has similar weight loss in comparison to standard Roux-en-Y gastric bypass.

An Incidental Finding of Gastric Mucosa-Associated Lymphoma (MALToma) in a Sleeve Gastrectomy with Literature Review

Mucosal-associated lymphoid tissue (MALT) lymphoma can typically be identified as a mass lesion or nodularity endoscopically and macroscopically. We report an incidental finding of a Helicobacter pylori gastric mucosal-associated lymphoid tissue (MALT) lymphoma in a sleeve gastrectomy specimen with no gross examination findings.

Gastric MALT lymphoma and grade II obesity: gastric bypass surgery as a therapeutic option

Mucosa-associated lymphoid tissue (MALT) is the most common extranodal lymphoma, with one third of the cases occurring in the stomach. Surgical treatment is a possible option. This case report describes an obese woman (body mass index 46 kg/m2) seeking bariatric surgery, with elevated serum cholesterol and uric acid, negative for Helicobacter pylori but with a positive biopsy for MALT (immunohistochemistry), stage IA. She was submitted to a Roux-en-Y gastric bypass and gastric resection. Two months later, she had lost 20 kg and the MALT lymphoma was in complete remission.

Laparoscopic staged adjustable gastric banding and liver resection in morbidly obese patient

We report the case of a 34-year old morbidly obese female, with a history of polycystic ovarian syndrome and birth control pill therapy, who underwent laparoscopic gastric banding. On laparoscopic exploration, a 4-cm liver neoplasm that was missed by preoperative ultrasound was incidentally found. The intraoperative biopsy was suggestive for a benign lesion of hepatocellular origin but could not make the differential diagnosis between focal nodular hyperplasia and adenoma. The neoplasm had atypical features on postoperative magnetic resonance imaging and was suggestive of liver adenoma. Six months after laparoscopic gastric banding, the patient presented with a weight loss of 24 kg and consented to liver resection. A laparoscopic resection of liver segment 3 was performed. Atypical liver neoplasms are subject to potential degeneration, rupture, and bleeding; therefore, they should be treated surgically to allow final diagnosis and potential cure of the disease. In this case, a staged approach was effective in obtaining substantial weight loss and a lesser degree of liver steatosis to enable the performance of a laparoscopic liver resection.