PMC5406540_01
CT Pouchography.
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PMC5406540_01_gr1.jpg
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CT Pouchography (Fig. 1) showed the hiatal hernia (Fig. 2) and a suspected functional stenosis at the angulus.
Division of the duodenojejunostomy.
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PMC5406540_01_gr3.jpg
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First, important adhesions had to been reduced, than duodenojejunostomy was divided (Fig. 3).
Resection of the distal part of sleeve.
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PMC5406540_01_gr4.jpg
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Gastric pouch was created as a long tubular pouch against a 42 Fr bougie and distal part of the sleeve was resected (Fig. 4).
Creation of the gastroenterostomy.
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PMC5406540_01_gr5.jpg
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Anastomosis was performed 200 cm after Treitz as a gastroenterostomy with a linear stapler (45 mm) and a 24 Fr tube for calibration (Fig. 5).