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Laparoscopic revision of gastrojejunostomy and vagotomy for intractable marginal ulcer after revised gastric bypass
The incidence of marginal ulceration after gastric bypass has been reported with significant variability (1–16%) [1]. Although its pathogenesis is unclear, several factors are associated with ulcer formation, including acid exposure, ischemia, foreign body, medications, and tobacco. In general, pharmacologic therapy is highly effective for ulcer healing, and surgical intervention is usually reserved for complications—typically bleeding or perforation. Rarely, surgical intervention is indicated for cases refractory to medical therapy.Plication followed by resection for intussusception after laparoscopic gastric bypass
Laparoscopic Roux-en-Y gastric bypass is the most commonly performed surgical intervention for morbid obesity. Internal hernias are the most common cause of postoperative bowel obstruction after laparoscopic Roux-en-Y gastric bypass, with a reported incidence of 3.1% despite mesenteric defect closure [1,2]. A less common cause of postoperative bowel obstruction is small bowel intussusception.
