title: Laparoscopic gastric bypass with subtotal gastrectomy for a super-obese patient with Biermer anemia.
abstract: Laparoscopic Roux-en-Y gastric bypass (RYGBP) is a common procedure for morbid obesity. After RYGBP, the bypassed stomach is unavailable for follow-up. Biermer anemia is an autoimmune atrophic gastritis inducing vitamin B12 deficiency and it is a risk factor for gastric carcinoma. A 41-year-old woman with a long history of morbid obesity presented with a BMI of 56 kg/m2. She had anemia (Hb 9.9 g/dL), and atrophic gastritis was found endoscopically. We performed a laparoscopic RYGBP with subtotal gastrectomy, to avoid the risk of gastric carcinoma in the bypassed stomach. The patient was discharged 9 days after the operation without complication. At 18 months follow-up, her BMI was 39 kg/m2 (50% excess weight loss). Laparoscopic RYGBP with subtotal gastrectomy is a safe treatment for morbid obesity, which should be considered for patients with a risk factor for gastric carcinoma.
authors.affiliation: Clinique des Emailleurs, General Digestive Surgery, Limoges, France.
authors.forename: Maxime
authors.initials: M
authors.lastname: Sodji
authors.forename: Frédéric A
authors.initials: FA
authors.lastname: Sebag
authors.forename: Jean Marc
authors.initials: JM
authors.lastname: Catheline
mesh_terms: D000328:Adult; D000752:Anemia, Pernicious / Q000453:epidemiology*; D005260:Female; D005743:Gastrectomy; D015390:Gastric Bypass / Q000379:methods*; D006801:Humans; D010535:Laparoscopy; D009767:Obesity, Morbid / Q000453:epidemiology* / Q000601:surgery; D012307:Risk Factors; D013274:Stomach Neoplasms / Q000453:epidemiology / Q000517:prevention & control*