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Background: One anastomosis gastric bypass (OAGB) may expose the patient to certain specific complications. Here, we report the results of conversion of OAGB to Roux-en-Y gastric bypass (RYGB) in terms of outcomes and weight loss., Methods: Between January 2009 and January 2019, all patients undergoing conversion of OAGB to RYGB because of complications due to OAGB (n = 23) were included. The primary efficacy endpoint was the effectiveness of converting OAGB to RYGB. The secondary endpoints were overall mortality and morbidity during the first 3 postoperative months, specific morbidity, reoperation, length of hospitalization, weight loss, and progression of comorbidities related to obesity at 2-year follow-up., Results: Indications for conversion were bile reflux (n = 14; 60.9%), severe malnutrition (n = 3; 13%), gastro-gastric fistula (n = 4; 17.4%), and anastomotic leak (n = 2; 8.7%). The median time interval between OAGB and conversion to RYGB was 34 months (0-158). At the time of RYGB, median body mass index (BMI) was 28.0 kg/m 2 (18.2-50.7), representing a median BMI change of 14.0 (- 1.7-43.5). Fifteen surgeries (65.1%) were completed laparoscopically. Five complications (21.7%) were recorded, including 2 major ones (8.7%). Reoperation rate was 4.3% (n = 1). At 24 months of follow-up (n = 18; 78.3%), median BMI was 28.7 kg/m 2 (19.4-35.4), representing a median BMI change of 19.5 (12.2-43.1). No patient complained of bile reflux or persistent malnutrition., Conclusion: RYGB performed as revisional surgery for complications after OAGB is an effective procedure with no major weight regain at 2 years of follow-up., (© 2022. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

The name and the email information of one of the author on the original published version of this article were presented incorrectly. The author name "Hamdi Brham" with email information Hamdi.brham@ch-simoneveil.fr should have been presented as "Hamdi Braham" with the correct email information, Hamdi.braham@ch-simoneveil.fr.

Introduction: We present the case of a diabetic patient on treatment with acarbose who had presented a sigmoid volvulus with localized cystic pneumatosis of the sigmoid colon., Case Report: A 72-year-old patient with a medical history of atrial fibrillation, DNID in treatment since 10 years by acarbose. The patient was admitted to the emergency for abdominal pain and occlusive syndrome since 48 h without fever or nausea or vomiting. A CT scan was performed that showed a dolichocolon with a sigmoid volvulus. The colonic wall was thickening as well as submucosal and subserosal gas, without extra digestive air or collections. A rectosigmoidoscopy was achieving that showed a sigmoid volvulus with multiple small projections like a submucosa gas bubbles. A laparoscopic non-oncologic sigmoidectomy with primary termino terminal colorectal anastomosis was performed. During the surgical procedure, an aspect of PCI of the sigmoid colon was found. The sigmoid colon was long like a dolichocolon, dilated, and partially twisted., Discussion: PCI is a rare condition characterized by the presence of multiple pneumokystes at different layers of the colonic wall. In emergency setting, the presence of colonic pneumatosis precludes the differential diagnosis between the PCI and mesenteric ischemia or ischemic colitis. It can be the cause of unnecessary explorative laparotomy., Conclusion: PCI is rare disease, in emergency setting, we had to consider in differential diagnosis with colonic vascular disorders.

Background: Few series are available on the results of repeat sleeve gastrectomy (re-SG) and Roux-en-Y gastric bypass (RYGB) performed to manage the failure of primary sleeve gastrectomy (SG). The objective of this study was to compare the short- and medium-term outcomes of re-SG and RYGB after SG., Material & Methods: Between January 2010 and December 2017, patients undergoing re-SG (n = 61) and RYGB (n = 83) for failure of primary SG were included in this study. Revisional surgery was proposed for patients with insufficient excess weight loss (EWL ≤ 50%) or weight regain. The primary endpoint was the comparison of weight loss in the re-SG group and the RYGB group at the 1-year follow-up. The secondary endpoints were overall mortality and morbidity, specific morbidity, length of stay, weight loss, and correction of comorbidities., Results: The mean interval between SG and re-SG was 41.5 vs. 43.2 months between SG and RYGB (p = 0.32). The mean operative time was 103 min (re-SG group) vs. 129.4 min (RYGB group). One death (1.7%; re-SG group) and 25 complications (17.4%; 9 in the re-SG group, 16 in the RYGB group) were observed. At the 1 year, mean body mass index was 31.6 in the re-SG group and 32.5 in the RYGB group (p = 0.61) and excess weight loss was 69.5 vs. 61.2, respectively (p = 0.05)., Conclusion: Re-SG and RYGB as revisional surgery for SG are feasible with acceptable outcomes and similar results on weight loss on the first postoperative year.

Aim: The management of acute mild biliary pancreatitis is multidisciplinary and still presents controversies in the diagnostic and therapeutic strategies. The aim of this retrospective study is to establish if a risk stratification of choledocholithiasis can optimize the employment of technological resources and medical competence in the treatment of individual patients in a tailored way. Our personal experience has then been compared with international literature. The main end-point was to evaluate the incidence of recurrence of acute pancreatitis. Secondary end point was to propose an affordable diagnostic and therapeutic algorithm for this relatively common disease., Methods: One hundred and one (101) patients affected by acute mild biliary pancreatitis were admitted in the Department of Patologia Chirurgica of "Ospedale SS. Annunziata" of Chieti from January 2004 to June 2011. Patients were divided in three groups; high (I), medium (II) and low risk (III) of choledocholithiasis (CBDS) according to clinical, laboratory and instrumental criteria. On the base of this division, patients in group I were subjected to ERCP with endoscopic sphinterotomy (ES) and subsequent laparoscopic cholecystectomy (LC). Group II patients underwent to MRCP, if positive for CBDS followed by ES and subsequently LC, if negative for CBDS directly LC. Group III patients underwent directly to LC associated with intra-operative cholangiography in selected cases., Results: No recurrence of acute pancreatitis was observed in patients who completed the diagnostic and therapeutic procedures., Conclusion: We believe that the application of a patient stratification in risk groups for choledocholithiasis can optimize the use of medical and technological resources and helps to address a patient for a specific and more appropriate diagnostic and therapeutic investigation allowing, at the same time, to identify patients who can usefully undergo to a simplified diagnostic and therapeutic approach.