PMC9851657_01
*Severe hepatic steatosis, severe protein-calorie malnutrition, anemia III, water-electrolyte imbalance and uncomplicated urinary tract infection.
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She had no history of chronic degenerative diseases or drug addiction (Fig. 1).
Gastric pouch, remaining stomach and gastrojejunostomy.
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We performed adhesiolysis, used a harmonic scalpel to release intestinal loops and identified the gastric pouch (which was tight and measured < 15 cm long), remaining stomach, gastrojejunostomy and the common limb (~200 cm), the total intestinal length was 600 cm (Fig. 2).
Gastrogastric anastomosis and upper dome closure.
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We proceeded to make a new gastric pouch with a black staple (60 mm) and performed a gastro-gastro anastomosis with a purple staple (45 mm) (Fig. 3).
Jejunojejunal anastomosis.
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The angle of Treitz was identified, and we found the jejunojejunostomy at 200 cm (Fig. 4).
Resection of gastroileal anastomosis.
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We later identified the gastroileal anastomosis, proceeded to resect that segment of 15 cm (Fig. 5) and the surgical procedure was completed.