Objective: Identify the incidence of Petersen's hernia in gastric bypass patients at our institution. Summary: Laparoscopic gastric bypass has proved to be the best treatment for obesity and the resolution of their complications, however, it presents long-term complications such as Petersen's hernia. Methods: A retrospective study of a single center, with a total of 225 gastric bypass performed in the bariatric and metabolic surgery clinic of the Hospital Civil de Guadalajara “Dr. Juan I. Menchaca” from January 2014 to March 2020. Results: Of the 225 operated patients, a global follow-up of 80.44% was obtained, with an average postoperative follow-up of 31 (+/-20.92) months, it was found that in 10 patients (4.44%) presented a symptomatic internal hernia. Of these, 9 patients was admitted to the emergency room and 1 detected in the outpatient clinic. These patients presented at the time of surgery a BMI of 27.65 (+/- 5.01) with a percentage of excess weight lost of 62.35% (+/- 25.60). The laparoscopic approach could be completed in 100% of the cases. Regarding hospital stay, an average of 1.1 (+/- 0.31) days was presented. No trans-surgical complications or mortality were reported in the group studied. The mean time between primary surgery and reoperation was 21.3 (+/- 12.98) months. Conclusion: In a 6-year period with a global follow-up of 80.44%, where the Petersen defect was not closed. An incidence of 4.44% was found, with an average follow-up of 31 (+/- 20.92) months. However, the percentage of Petersen's hernia may be underestimated since only those with symptoms that lead the patient to emergency care are usually diagnosed, so a high index of suspicion must always be had.

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Background: There has been increased interest in identifying the associated factors to Type 2 Diabetes Mellitus (T2DM) remission after bariatric surgery. One of these factors is the BP limb length. The objective of our study was to evaluate the T2DM remission rate in patients subjected to Roux -en- Y gastric bypass (RYGB) who had different Biliopancreatic (BP) limbs length. Methods: 48 patients with obesity grade II, and T2DM diagnosis, were subjected to RYGB and completed a one year of surgical follow up. All patients were grouped according to the BP limb length: In group A (n= 24) patients with BP limbs of 100 cm or less; in group B (n= 24) patients with BP limb from 150 to 170 cm in length. Results: Both groups presented an elevated remission rate of T2DM (83% full remission in the population studied). In group A 18 patients (75%) presented a full remission, while 2 patients (8.3%) showed a partial remission and only 4 patients (16.7%) were considered without remission at the one year follow up. In group B all patients had some remission: 22 patients (91.7%) presented a full remission (91.7%) and the rest of the patients showed a partial remission (8.3%), no significant difference was found between the two groups. Conclusions: Bariatric surgery remains as the best long term treatment for obesity and its comorbidities, despite some differences in the RYGB technique, BP limb length from 50 to 170 cm did not affect post RYGB glycemic control.