Pereyra-Talamantes A, Benítez-González JL, Juárez-Herrera A, Vergara-Tamayo EA, Rodríguez-Silverio JE

Language: Spanish
References: 13
Page: 33-38
PDF size: 941.23 Kb.

ABSTRACT

Introduction: bariatric surgery has evolved with the development of effective techniques for weight loss and remission of obesity-related comorbidities. The single anastomosis sleeve ileal (SASI) gastric bypass, which combines sleeve gastrectomy with a single ileal anastomosis, is an emerging procedure. However, as it is not yet standardized, available evidence regarding its safety, outcomes, and complication management remains limited. Literature addressing revisional surgery after SASI is scarce; therefore, reporting this clinical experience is relevant to expand the current knowledge. Case report: we present the case of a 58-year-old male patient with a history of sleeve gastrectomy performed in 2012 and an initial body mass index (BMI) of 39.8 kg/m², who developed weight regain due to poor adherence to follow-up. In March 2024, he underwent conversion to SASI for persistent obesity and gastroesophageal reflux disease. Postoperatively, he developed epigastric pain, nausea, vomiting, and food intolerance. Imaging studies and endoscopy revealed severe prepyloric stenosis and a threadlike passage through the gastroileal anastomosis. After failure of conservative management and clinical relapse, laparoscopic conversion to Roux-en-Y gastric bypass was performed, with favorable outcomes and adequate oral tolerance. Conclusions: this report documents the resolution of gastroileal stenosis following a SASI procedure through laparoscopic conversion to Roux-en-Y gastric bypass, as an effective therapeutic option.

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