Acute Gastric Dilation of the Post-Roux-en-Y Gastric Bypass Remnant Stomach: Image-Guided Surgery Approach

Background:Bariatric surgery is an effective treatment for obesity and its associated morbidities. They are safe surgeries, their general complication rate is 0%-10%. However, acute gastric dilation is an unusual complication. It requires rapid diagnosis and treatment to avoid major complications. Image-guided surgery represents a group of minimally invasive procedures. Acute gastric dilation is a complication that can benefit from the application of this type of procedure. We present a report of patients with acute gastric dilation of the remnant as a complication after bariatric surgery, its resolution through image-guided surgery, and updating. Materials and Methods:A retrospective review of patients who presented postoperative complications after bariatric surgery was carried out. The time period was 10 years. All patients were operated on in a single center by the same surgical team. Results:A total of 3507 bariatric procedures were analyzed (sleeve gastrectomy, 1929-55.1% +/- 0.49%; Roux-en-Y gastric bypass [RYGB], 1403-40% +/- 0.48%; other techniques, 175-4.9% +/- 0.21%). The RYGB branch reported a total of 11 (0.78% +/- 0.08%) complications, of which 2 (0.14% +/- 0.03%) were reported as acute gastric dilation of the remnant. Conclusions:Acute gastric dilation of the post-RYGB remnant is a rare complication, but it can be serious. It is necessary to have a high suspicion to obtain an early diagnosis and treatment. Percutaneous gastrostomy is an image-guided procedure that can solve the problem temporarily or permanently.