• Hang Yu, Xing Kang, and Xitai Sun.
• Department of General Surgery, Nanjing Drum Tower Hospital Clinical College of Nanjing University of Chinese Medicine, Nanjing, China.
• Medicine (Baltimore). 2023 Oct 27; 102 (43): e35077e35077.

RationaleLaparoscopic 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 ConcernsThe 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.DiagnosesDilatation of the gastric pouch was observed on iodinated water imaging of the upper gastrointestinal tract and on abdominal CT.InterventionsWe report 2 patients with dilated gastric bursa after RYGB, both female, who underwent gastric diversion revision.OutcomesBoth 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.LessonsThe 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.Copyright © 2023 the Author(s). Published by Wolters Kluwer Health, Inc.

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