Bile reflux after Roux-en-Y gastric bypass: an unrecognized cause of postoperative pain.

Background: To determine, in a private practice, whether symptomatic bile reflux can occur after Roux-en-Y gastric bypass (RYGB) for morbid obesity and the outcome after laparoscopic alimentary (Roux) limb lengthening. Bile reflux as a cause of pain after laparoscopic RYGB has not been previously described. We report on a series of patients with chronic pain after RYGB as a result of bile reflux owing an abnormally short alimentary limb.

Perforated marginal ulcers after laparoscopic gastric bypass.

Background: Perforated marginal ulcer (PMU) after laparoscopic Roux-en-Y gastric bypass (LRYGB) is a serious complication, but its incidence and etiology have rarely been investigated. Therefore, a retrospective review of all patients undergoing LRYGB at the authors' center was conducted to determine the incidence of PMU and whether any causative factors were present.

Methods: A prospectively kept database of all patients at the authors' bariatric center was retrospectively reviewed.

Anastomotic stenosis after Roux-en-Y gastric bypass: A rational approach to treatment.

Background: Anastomotic stenosis, a common sequela to Roux-en-Y gastric bypass, has a reported incidence of 1.6-27% and recurs in 17-33%. No universal guidelines for optimal treatment exist.

Elective cholecystectomy after Roux-en-Y gastric bypass: why should asymptomatic gallstones be treated differently in morbidly obese patients?

Background: Gallbladder management in bariatric surgery varies. Some surgeons perform routine cholecystectomy with bariatric surgery, and others selectively base that decision on routine preoperative ultrasound findings. Both approaches treat bariatric patients differently than the normal-weight population in whom cholecystectomy is not performed in asymptomatic patients.

Acute mesenteric venous thrombosis following laparoscopic Roux-en-Y gastric bypass.

Background And Objectives: Acute mesenteric venous thrombosis has not been previously reported as a complication following Roux-en-Y gastric bypass.

Methods: The authors present 3 cases from a single-center experience of over 1500 patients as well as a review of the literature.

Results: The presenting symptoms are nonspecific, and the diagnosis is often made after infarction of the intestine has occurred.

Conversion of laparoscopic Roux-en-Y gastric bypass.

Background: To determine the incidence and causes of conversion from a laparoscopic to an open gastric bypass for morbid obesity, we reviewed the experience of our bariatric center.

Methods: We performed a retrospective review of the records of consecutive patients undergoing laparoscopic Roux-en-Y gastric bypass at our center.

Results: In all, 1,236 consecutive patients with body mass indes (BMI) from 35 to 82 were approached laparoscopically.