To the Editor.—With the introduction of any new surgical procedure, unanticipated complications are encountered. We herein describe a complication, previously unreported, of a relatively new operation, the pancreaticobiliary bypass for morbid obesity (Scopinaro procedure).1 This procedure consists of two-thirds gastrectomy with closure of the duodenal stump, division of the small bowel at its midportion, anastomosis of the distal end of the small bowel to the stomach (Roux-en-Y gastroenterostomy), and connection of the distal end of the bypassed proxymal intestine to the terminal ileum.
Report of a Case.—A 33-year-old pregnant woman presented to an outlying hospital with midabdominal pain. Four years before this episode, she underwent the Scopinaro operation. The clincal picture and the elevated serum amylase level (3000 U/L) led to the diagnosis of acute pancreatitis, for which conservative treatment was instituted. After an initial improvement, her condition deteriorated, and she was transferred to our hospital.