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- Laparoscopic treatment of a gastro-gastric fistula after Roux-en-Y gastric bypass—report of two casesPublication . Gaspar, Joana; Marques, Paula; Mesquita, Isabel; Marcos, Mário; Santos, Jorge; Nogueira, CarlosThe most frequently performed bariatric surgery is the laparoscopic Roux-en-Y gastric bypass (LRYGB). An uncommon complication of LRYGB is gastro-gastric fistula (GGF). Possible causes of GGF include incomplete transection of the stomach during the initial surgery, staple-line leaks in the post-operative period and marginal ulcers. The optimal management of GGF is still under debate, with medical, endoscopic and surgical treatment modalities available. The authors present two cases of a GGF successfully managed with a laparoscopic surgical approach, after failed medical and endoscopic treatment.