Postoperative dystocia of the gastric bursa after LRYGB: A case report

RATIONALE: Laparoscopic Roux-en-Y gastric diversion is one of the most widely used surgical procedures for weight reduction and metabolic surgery, which is a hybrid approach to restrict intake and reduce absorption. Despite the successful completion of laparoscopic Roux-en-Y gastric diversion, 10% to 20% of patients still experience regained body mass or other complications. PATIENT CONCERNS: The patient had regained weight after all the RYGB surgeries, and after diet and exercise control, the results were not good, so she came to our department for treatment. DIAGNOSES: Dilatation of the gastric pouch was observed on iodinated water imaging of the upper gastrointestinal tract and on abdominal CT. INTERVENTIONS: We report 2 patients with dilated gastric bursa after RYGB, both female, who underwent gastric diversion revision. OUTCOMES: Both patients in this case underwent laparoscopic gastric diversion correction to improve weight rebound. Their quality of life improved significantly after treatment. There were no grade 3/4 treatment-related adverse events during the treatment period. LESSONS: The above cases suggest that patients who regain weight after RYGB should routinely undergo preoperative upper gastrointestinal endoscopy and upper gastrointestinal iodine hydrography in order to observe the muscle tone of the patient’s gastric bursa and the degree of dilatation of the gastrointestinal anastomosis and consider whether to correct the dilated gastric bursa intraoperatively before converting to LSG.