Pancreaticoduodenectomy in Patients with Previous Roux-en-Y Gastric Bypass: a Matched Case-Control Study

Tsamalaidze, Levan; Asbun, Horacio J.; Costa, R. Montenegro; Olival, Luciano D.; Stauffer, John

doi:10.1007/s11695-019-04068-z

Cited by 1 publication

(1 citation statement)

References 11 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Younan et al described a method in which the gastric remnant is preserved and used for pancreaticogastrostomy (PG) reconstruction and subsequently drained by the same jejunal limb used for the HJ (17). Tsamalaidze et al reported that out of seven patients with stomach preservation, the remnant stomach was used for pancreatic reconstruction in three patients and two patients had insertion of transgastric jejunal feeding tube for nutrition (18). One of the potential benefits is a tension-free anastomosis due to the proximity of the posterior gastric wall to the pancreas with reduced risk of post-operative pancreatic fistula.…”

Section: Discussionmentioning

confidence: 99%

Pancreaticoduodenectomy after Roux-en-Y Gastric Bypass: a novel reconstruction technique

Mak¹,

Shelat²

2022

Transl Gastroenterol Hepatol

View full text Add to dashboard Cite

BackgroundThe obesity epidemic continues to increase around the world with its attendant complications of metabolic syndrome and increased risk of malignancies (1), including pancreatic malignancy (2,3). The Roux-en-Y gastric bypass (RYGB) effectively treats obesity and its associated morbidities including metabolic syndrome (4). RYGB creates a gastric pouch with alimentary limb, as well as a biliopancreatic (BP) limb that joins the alimentary limb to form a common channel. Thus, it has both restrictive and mal-absorptive components. Patients with a mass in the head of pancreas are recommended pancreaticoduodenectomy (PD) for suspected malignancy (5). As bariatric surgery is increasingly adopted in recent years (6), more reports of PD following RYGB are published. Post-surgical adhesions and altered anatomy following RYGB poses not only a diagnostic challenge by making endoscopy difficult, but also unique challenge of reconstruction following PD. There are many different techniques of reconstruction proposed. Here we describe a patient where the remnant BP limb was used for a venting anterior gastrojejunostomy. The pancreaticojejunostomy and hepaticojejunostomy was created with a new loop of jejunum and a new distal jejunojejunostomy was performed. MethodsA 59-year-old male presented with painless obstructive jaundice of one week's duration. He had a history of RYGB

show abstract

Section: Discussionmentioning

confidence: 99%