Access to the bypassed stomach is difficult following laparoscopic Roux-en-Y gastric bypass (LRYGBP). The bypassed stomach is not readily available for endoscopic or radiographic evaluation. Diagnosis and treatment of peptic ulcer disease and its complications in the excluded stomach becomes difficult. We present a case of perforation in the bypassed stomach following LRYGBP secondary to peptic ulcer disease.
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- A 60s male patient diagnosed with advanced gastric cancer (with pyloric stenosis and enlarged lymph nodes) experienced significant tumor reduction after two courses of chemotherapy before surgery.
- He underwent laparoscopic gastric jejunal bypass followed by distal gastrectomy and para-aortic lymph node dissection, with positive surgical results and no further tumor growth observed.
- After the operation, he received a year of adjuvant chemotherapy and has remained recurrence-free for 1.5 years, highlighting the effectiveness of preoperative treatment for this condition.
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