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Harvey Sugerman, MD

Arch Surg. 2007;142(10):1004.

	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

This is a thoughtful, thorough analysis of the actual and potential risks of loop gastric bypass, also known as mini–gastric bypass. As stated in the article, several of these patients required revision to a Roux-en-Y procedure because of severe bile reflux gastritis or esophagitis symptoms.¹ There is 1 reference to constructing a jejunojejunostomy below the loop gastrojejunostomy to relieve bile reflux symptoms, also known as the Braun procedure.² Some surgeons have been performing loop gastric bypass in combination with a Braun procedure as their primary operation to prevent this complication. This obviates the potential advantage of loop gastric bypass because it entails 2 operations and does not eliminate bile reflux, since the afferent limb still brings bile through peristalsis into the stomach. This procedure has also been used to treat efferent jejunal limb obstruction after a mini–gastric bypass.³ However, as pointed out in this study, the . . . [Full Text of this Article]

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Gastric Bypass: Why Roux-en-Y? A Review of Experimental Data
Brendan J. Collins, Tomoharu Miyashita, Michael Schweitzer, Thomas Magnuson, and John W. Harmon
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