Salvage Surgery for Severe Post-Bariatric Hypoglycemia After Multiple Bariatric Revisions: Reversing Roux-en-Y Gastric Bypass to Sleeve with Roux Limb as Henley-Longmire Interposition

Abstract

Despite excellent weight loss and resolution of comorbidities experienced by most patients, Roux-en-Y gastric bypass (RYGB) is known to cause long-term complications that may necessitate revisional intervention or surgery. Post-bariatric hypoglycemia (PBH) is an increasingly recognized RYGB complication afecting 0.1–34% of patients [1–3], which can impact their quality of life [4]. In rare cases, reversing RYGB and restoring normal food passage may be considered due to severe PBH that is refractory to extensive therapeutic interventions [1, 5, 6]. However, reversal procedures carry a high risk of complications and usually require long operative times [7–10].