RESUMO
One anastomosis gastric bypass (OAGB), the third most commonly performed procedure worldwide, has shown excellent results in terms of weight loss and resolution of comorbidities compared with other bariatric surgeries. However, its use remains limited in various parts of the world due to postoperative complications. After the efficacy of this procedure was established, the focus of treatment shifted toward resolving postoperative complications. Protein-energy malnutrition after OAGB is one of the main issues that needs to be addressed. There are several operative options for patients who require revision surgery including reversal and conversion to Roux-en-Y gastric bypass (RYGB). The conversion from OAGB to RYGB is a feasible method that has shown excellent results when performed by experts in the field. Here, we present the case of a woman with symptoms of acute obstruction secondary to OAGB who underwent conversion to RYGB under emergent conditions.
RESUMO
True left-sided gallbladder (LSGB) is a rare congenital anomaly with an incidence of 0.1-1.2%. It is more common in women than in men at a ratio of 5:1. Its etiology is unknown, although several theories have been proposed. The symptoms are similar to those of a normal gallbladder, which makes the preoperative diagnosis difficult despite imaging studies. In most cases, the diagnosis is achieved intraoperatively. LSGB is associated with biliary anomalies, and the incidence of biliary tract lesions is high. Four-port laparoscopic cholecystectomy is a safe procedure for LSGB. Surgical technique varies according to each case. Preoperative imaging studies have low sensitivity for diagnosis, and the surgeon should be familiar with ductal and vascular anatomical variants in addition to possessing the ability to change the conventional surgical technique to optimize the exposure and minimize the risk of bile duct injury.