Conversion from mini bypass to laparoscopic Roux en Y gastric bypass in an emergency setting: Case report and literature review

Emergent conversion from single-anastomosis gastric bypass to Roux-en-Y gastric bypass with subsequent obstruction of entero-enteric anastomosis by ascaris

One anastomosis gastric bypass (OAGB), the third most commonly performed procedure worldwide, has shown excellent results in terms of weight loss and resolution of comorbidities compared with other bariatric surgeries. However, its use remains limited in various parts of the world due to postoperative complications. After the efficacy of this procedure was established, the focus of treatment shifted toward resolving postoperative complications. Protein-energy malnutrition after OAGB is one of the main issues that needs to be addressed. There are several operative options for patients who require revision surgery including reversal and conversion to Roux-en-Y gastric bypass (RYGB). The conversion from OAGB to RYGB is a feasible method that has shown excellent results when performed by experts in the field. Here, we present the case of a woman with symptoms of acute obstruction secondary to OAGB who underwent conversion to RYGB under emergent conditions.

Bile reflux after one anastomosis gastric bypass surgery: A review study

Background

Recently the performance rate of one anastomosis gastric bypass (OAGB) bariatric surgery has increased. Bile reflux is on of common considered complication of OAGB challenging surgeon.

Methods

We searched English full text with keyword "bile reflux" AND "OAGB" OR "one anastomosis gastric bypass" OR "SAGB" OR "single anastomosis gastric bypass" that published from January 1st, 2000 to December 31st, 2020 in PubMed, EMBASE, Google scholar and Cochrane Library. We included prospective or retrospective systematic review, review, clinical, and meta-analysis human article that its full text was available and focused on bile reflux after OAGB/SAGB as the fundamental performed bariatric surgery.

Results

A total of 1259 articles were analyzed, of which 5 were included. Analysis of number articles by year revealed that 2019 and 2020 was the highest number of published articles (n = 232; 68%). Study type analysis revealed that review studies and clinical research (n = 62; 18.2%) were the most frequent study types. Reported data on bile reflux after OAGB had diversity. Implicitly, postoperative incidence of bile reflux differed from 7.8 to 55.5%. General consensus was not existed among authors to consider the OAGB as the first suspect leading to postoperative bile reflux among other bariatric surgery types.

Conclusion

Although surgeons prefer to conduct OAGB procedure because of its easier surgical approach needing just one anastomosis formation it is not virtually clear that is the procedure costly benefitted regarding bile reflux outcomes.