title: Emergency laparoscopic conversion from mini/one anastomosis gastric bypass to modified Roux-en-Y-gastric bypass due to acute bleeding from a recurrent marginal ulcer.
abstract: Our aim is to present the laparoscopic technique of an emergency revisional procedure performed to convert a mini/one anastomosis gastric bypass (MGB/OAGB) to a modified Roux-en-Y-gastric-bypass (RYGB) due to recurrent bleeding from a marginal ulcer. A 43 year old woman presented unstable conditions due to acute bleeding from a marginal ulcer after a MGB/OAGB performed 3 years before. After three failed endoscopic haemostasis attempts, she underwent a laparoscopic conversion to a modified RYGB in emergency setting. The patient had an uneventful recovery. She maintained heamodynamical stability after the procedure. She was eventually discharged in the seventh postoperative day after restarting oral feeding on chronic proton pump inhibitors. To our knowledge, there are few descriptions of emergency surgical conversion from a MGB/OAGB to a modified laparoscopic RYGB due to a recurrent marginal ulcer bleeding not responsive to endoscopic treatment. A regular post-operative follow-up is mandatory after bariatric surgery. We advocate performing revisional surgery in an experienced Bariatric Center.
authors.affiliation: Department of Surgery, Dolo Hospital, Via Pasteur, 30031, Dolo, VE, Italy.
authors.forename: Mario
authors.initials: M
authors.lastname: Godina
authors.affiliation: Department of Surgery, San Giovanni Hospital, Via Fatebenefratelli 34, 34170, Gorizia, Italy. carlonagliati@yahoo.it.
authors.forename: Carlo
authors.initials: C
authors.lastname: Nagliati
authors.affiliation: Department of Surgery, Dolo Hospital, Via Pasteur, 30031, Dolo, VE, Italy.
authors.forename: Paola
authors.initials: P
authors.lastname: Menegon
authors.affiliation: Department of Surgery, Dolo Hospital, Via Pasteur, 30031, Dolo, VE, Italy.
authors.forename: Valentina
authors.initials: V
authors.lastname: Caruso
mesh_terms: D000328:Adult; D000714:Anastomosis, Surgical / Q000379:methods; D004630:Emergencies; D005260:Female; D015390:Gastric Bypass / Q000379:methods*; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D010437:Peptic Ulcer / Q000209:etiology / Q000601:surgery*; D010438:Peptic Ulcer Hemorrhage / Q000209:etiology / Q000601:surgery*; D011183:Postoperative Complications / Q000601:surgery*; D012008:Recurrence
keywords: Endoscopy; Gastrointestinal bleeding; Marginal ulcer; Mini gastric bypass; Revisional bariatric surgery