title: Laparoscopic Roux-en-Y gastric bypass with remnant gastrectomy for focal intestinal metaplasia of the gastric antrum.
abstract: BACKGROUND
  Inaccessibilility of the excluded stomach after isolated gastric bypass prevents postoperative evaluation and treatment of disorders of the gastric remnant. Bleeding complications, peptic ulcer disease, and gastric malignancy in the gastric remnant have all been reported. We report a patient with morbid obesity and focal intestinal metaplasia in the antrum of the stomach that was treated with laparoscopic Roux-en-y gastric bypass (LRYGBP) with remnant gastrectomy.
  
  
  METHODS
  A 46-year-old female with a long history of morbid obesity presented with a BMI of 47 kg/m2. Preoperative upper endoscopy revealed focal intestinal metaplasia. Since intestinal metaplasia is a risk factor for gastric cancer, a LRYGBP with remnant gastrectomy was performed.
  
  
  CONCLUSIONS
  LRYGBP with remnant gastrectomy is a safe and cost-effective treatment for morbidly obese patients with focal intestinal metaplasia of the stomach.
authors.affiliation: Division of Laparoscopic Surgery, Department of Surgery, Mount Sinai Medical Center, New York, NY, USA.
authors.forename: David C
authors.initials: DC
authors.lastname: Voellinger
authors.forename: William B
authors.initials: WB
authors.lastname: Inabnet
mesh_terms: D000713:Anastomosis, Roux-en-Y / Q000379:methods*; D016099:Endoscopy, Gastrointestinal / Q000379:methods; D005260:Female; D005743:Gastrectomy / Q000379:methods*; D015390:Gastric Bypass / Q000379:methods*; D018530:Gastric Stump / Q000473:pathology* / Q000601:surgery*; D005756:Gastritis / Q000175:diagnosis / Q000601:surgery; D005764:Gastroesophageal Reflux / Q000175:diagnosis / Q000601:surgery; D006551:Hernia, Hiatal / Q000175:diagnosis / Q000601:surgery; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D008679:Metaplasia; D008875:Middle Aged; D009767:Obesity, Morbid / Q000175:diagnosis / Q000601:surgery; D011706:Pyloric Antrum / Q000473:pathology / Q000601:surgery