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Laparoscopic OAGB resolves recurrent weight gain and symptoms in a patient with a gastro-gastric fistula, indicating a viable surgical option for complex cases.
A 56-year-old female presented with recurrent weight gain (RWG) and vomiting, 10 years after open VBG. Imaging and endoscopy revealed an anatomically distorted pouch, two staple line dehiscences, and a gastro-gastric fistula (GGF). Multiple revisional options were evaluated. Due to the presence of mesh and anatomical limitations, a decision was made to perform a one-anastomosis gastric bypass (OAGB) below the mesh, guided by a calibration tube passed through the area of disruption. Laparoscopic OAGB was performed with a 150-cm biliary limb and a 3-cm gastrojejunostomy. Intraoperative leak testing was negative. The patient had an uneventful recovery and was discharged on postoperative day 3. At 18-month follow-up, she achieved a weight of 74 kg (body mass index (BMI) 25.4 kg/m 2 ), with complete symptom resolution and normal laboratory parameters.
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Hany et al. (2025) studied this question.
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