BACKGROUND Despite the proliferation of laparoscopic Roux-en-Y gastric bypass (LRYGBP), postoperative bowel obstructions still occur from mesocolonic constrictions, internal hernias, and anastomotic strictures. Obstructed patients do not present with a characteristic history and physical. Therefore, radiographic studies including upper gastrointestinal films and computed tomography are essentia...

CONTEXT Roux-en Y gastric bypass surgery is the most common operation for treatment of morbid obesity. The approach to pancreaticoduodenal resection in patients with a history of Roux-en Y gastric bypass is not well described. CASE REPORTS Pancreaticoduodenal resection was performed in two patients with distal bile duct strictures, with a past history of Roux-en Y gastric bypass. In both case...

Background. Laparoscopic Roux-en-Y gastric bypass (LRYGB) has been shown to be an effective treatment for type 2 diabetes mellitus (T2DM) in patients with morbid obesity. However, it is unclear just how effective the LRYGB procedure is on T2DM for patients with BMI less than 35 kg/m(2). We report one obese patient with T2DM who did not meet the current NIH criteria for morbid obesity surgery. T...

OBJECTIVES To evaluate the relations between liver markers (GGT, ALT and AST) and the metabolic syndrome (and its components) in morbidly obese subjects, and to determine the response of these metabolic factors and hepatic enzymes after weight loss induced by Roux-en-Y gastric bypass. METHODS This study was carried out at a university hospital, in Santo André (SP), Brazil. We evaluated 140 mo...

OBJECTIVES Roux-en-Y gastric bypass is the gold standard for treating morbid obesity in this country. The totally laparoscopic performance of this procedure, although quite demanding and technically difficult, has revolutionized it; and the demand for it has skyrocketed. We describe 2 cases where it became necessary to convert the Y into a "W" while performing the procedure. METHODS A laparos...

OBJECTIVES This study reports the indications and outcome of various biliary bypass surgical procedures from a single centre over a period of 10 years. METHODS This is a prospective observational study conducted over a period of 10 years (January 2001-december 2010). A total of 1500 patients were included, who underwent pancreatico-biliary surgery due to common bile duct (CBD) stones, congeni...

BACKGROUND Ulcers at the gastrojejunostomy site are a common problem after gastric surgery. Their postoperative development seems to be associated with Helicobacter pylori-related gastritis or abuse of nicotine, alcohol or non-steroidal anti-inflammatory drugs (NSAIDs), but is also dependent on the choice of surgical method (Roux-en-Y or B-II gastric bypass). PATIENTS AND METHODS This study e...

Intrathoracic hernias after total gastrectomy are rare. We report the case of a 78-year-old man who underwent total gastrectomy with antecolic Roux-Y reconstruction for residual gastric cancer. He had alcoholic liver cirrhosis and received radical laparoscopic proximal gastrectomy for gastric cancer 3 years ago. Early gastric cancer in the remnant stomach was found by routine upper gastrointest...