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We systematically reviewed PubMed, Scopus, and Web of Science and included 26 reports (34 patients), alongside a video-illustrated late OAGB case. Mean age was 49 years, 73.5% were female, and BMI at presentation was 33.58\u00a0kg\/m\u00b2; 32 events followed RYGB and 2 OAGB, occurring a mean of 118.7 months postoperatively. CT was performed in 79.4% and more often showed free fluid than pneumoperitoneum. Laparoscopy (70.6%) with primary repair with or without omental flap or limited remnant resection achieved source control; no completion gastrectomies or 30-day deaths were reported. Early diagnostic laparoscopy should be considered in septic bypass patients with unexplained free fluid; however, the available evidence is limited to case reports and small case series, so definitive conclusions regarding incidence, comparative risk, or causative mechanisms cannot be drawn.<\/jats:p>","DOI":"10.1007\/s11695-026-08725-y","type":"journal-article","created":{"date-parts":[[2026,5,20]],"date-time":"2026-05-20T09:46:28Z","timestamp":1779270388000},"page":"3376-3389","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Excluded-stomach Perforation after Roux-en-Y and One-anastomosis Gastric Bypass: A Systematic Review with Video-illustrated Case Report"],"prefix":"10.1007","volume":"36","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6650-8112","authenticated-orcid":false,"given":"Mohamed","family":"Hany","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ala","family":"Wafa","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-1408-9628","authenticated-orcid":false,"given":"Mona S.","family":"Youssef","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7425-356X","authenticated-orcid":false,"given":"Mohamed H.","family":"Zidan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8031-838X","authenticated-orcid":false,"given":"Hashem","family":"Altabbaa","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8693-1364","authenticated-orcid":false,"given":"Hazem","family":"Al-Momani","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7244-0118","authenticated-orcid":false,"given":"Dina M.","family":"Hafez","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0961-1302","authenticated-orcid":false,"given":"Walid","family":"El Ansari","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6887-0235","authenticated-orcid":false,"given":"Mohamed","family":"Samir","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,5,20]]},"reference":[{"issue":"3","key":"8725_CR1","doi-asserted-by":"publisher","first-page":"935","DOI":"10.1007\/s11695-020-05093-z","volume":"31","author":"TC Soong","year":"2021","unstructured":"Soong TC, Lee MH, Lee WJ, Chen JC, Wu CC, Chun SC. 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For the case report, institutional policy did not mandate formal ethics committee approval for single anonymized case reports. The study was conducted in accordance with the principles of the Declaration of Helsinki. 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