How I do it Afferent loop obstruction (ALO) with hyper-amylasemia and deranged liver function test , are we going to see this complication more frequently again? Emergency conversion of One anastomosis gastric bypass (OAGB) to a Roux-en-Y Gastric bypass (

Abstract

Abstract

Afferent loop syndrome is a known complication of gastric surgery specifically after Billroth  II  and to a lesser extent a  Roux –en-Y reconstruction. However the incidence decreased over the years proportionally with the decrease in the number of gastric surgery.

Afferent loop syndrome can be either acute or chronic with different presentation and treatment options. The acute type can occur early post operatively or it could be delayed presentation. Acute ALS is associated with complete closed loop obstruction and considered a surgical emergency, whereas chronic ALS is mostly related to partial obstruction of the afferent loop.

This rare complication can occur after the single anastomosis gastric bypass (Omega loop bypass) as it is a type of Billroth II reconstruction of gastric pouch –jejunostomy.

With the increase in the number of SAGB performed all over the world as weight reduction surgery for morbidly obese patient s surgeons should be aware of this complication and the treatment options.