Chronic dilation of the gastric remnant is a rare complication, although it can be serious. It is due to an exaggerated distension of the gastric remnant after a Roux-en-Y gastric bypass (RYGB). Clinical suspicion and computed tomography (CT) are essential for its diagnosis. Its treatment is by means of a decompressive gastrostomy, which can be percutaneous or surgical, an option that can be carried out in certain patients. We present a clinical case of chronic dilation of the gastric remnant and its laparoscopic surgical resolution. We present a clinical case of a 67-year-old patient who underwent a RYGB. An abdominal CT scan showed chronic dilation of the gastric remnant. A laparoscopic biopsy and a laparoscopic-assisted percutaneous gastrostomy were performed. The combined percutaneous laparoscopic approach is a good option for cases of chronic gastric dilations of unknown origin, allowing to discover and treat its causes.
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