{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,2]],"date-time":"2026-09-02T18:20:08Z","timestamp":1788373208454,"version":"build-2803163510"},"reference-count":15,"publisher":"Oxford University Press (OUP)","issue":"9","license":[{"start":{"date-parts":[[2026,9,2]],"date-time":"2026-09-02T00:00:00Z","timestamp":1788307200000},"content-version":"vor","delay-in-days":2,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,8,31]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Single anastomosis sleeve ileal (SASI) bypass is an emerging bariatric procedure; some patients face complications such as severe bile reflux, requiring conversion. In this context, the surgical goal is to substantially reduce exposure of the stomach and gastroesophageal junction to bile acids to prevent early complications. We present a 46-year-old man with class III obesity (body mass index 54.6\u00a0kg\/m2) who 10\u00a0days after an uneventful SASI bypass, developed intense, persistent, refractory reflux. A diagnostic endoscopy revealed an extensive accumulation of biliary reflux in the gastric lumen, prompting reintervention. During anesthetic induction, the patient aspirated bile, causing acute respiratory distress. After intraoperative stabilization, the team proceeded without further incident, converting the single-loop configuration to a Roux-en-Y transit bipartition, resolving gastroesophageal reflux disease (GERD). This case underscores the need to incorporate prevention maneuvers during anesthetic induction in patients with severe GERD to avoid aspiration, and the importance of anticipating high anesthetic risk in these individuals.<\/jats:p>","DOI":"10.1093\/jscr\/rjag786","type":"journal-article","created":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T11:35:33Z","timestamp":1787052933000},"source":"Crossref","is-referenced-by-count":0,"title":["Bile aspiration during emergent revision of a single-anastomosis gastric (SASI) bypass to a Roux-en-Y configuration with transit bipartition: a case report"],"prefix":"10.1093","volume":"2026","author":[{"ORCID":"https:\/\/orcid.org\/0009-0007-3039-3190","authenticated-orcid":false,"given":"Mar\u00eda Emilia","family":"Salgado","sequence":"first","affiliation":[{"name":"Cl\u00ednica Bari\u00e1trica Dr. Napole\u00f3n Salgado , Av. Mariana de Jes\u00fas y Nu\u00f1o de Valderrama, 170509, Quito ,","place":["Ecuador"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-7872-7849","authenticated-orcid":false,"given":"Carolina","family":"Guevara","sequence":"additional","affiliation":[{"name":"Cl\u00ednica Bari\u00e1trica Dr. Napole\u00f3n Salgado , Av. Mariana de Jes\u00fas y Nu\u00f1o de Valderrama, 170509, Quito ,","place":["Ecuador"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-3569-7315","authenticated-orcid":false,"given":"Gabriel","family":"Carvajal","sequence":"additional","affiliation":[{"name":"Cl\u00ednica Bari\u00e1trica Dr. Napole\u00f3n Salgado , Av. Mariana de Jes\u00fas y Nu\u00f1o de Valderrama, 170509, Quito ,","place":["Ecuador"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-1231-5396","authenticated-orcid":false,"given":"Gabriela","family":"Zapata Jaramillo","sequence":"additional","affiliation":[{"name":"Cl\u00ednica Bari\u00e1trica Dr. Napole\u00f3n Salgado , Av. Mariana de Jes\u00fas y Nu\u00f1o de Valderrama, 170509, Quito ,","place":["Ecuador"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-1198-0833","authenticated-orcid":false,"given":"Napole\u00f3n","family":"Salgado Mac\u00edas","sequence":"additional","affiliation":[{"name":"Cl\u00ednica Bari\u00e1trica Dr. Napole\u00f3n Salgado , Av. Mariana de Jes\u00fas y Nu\u00f1o de Valderrama, 170509, Quito ,","place":["Ecuador"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2026,9,2]]},"reference":[{"key":"2026090214044443100_ref1","doi-asserted-by":"publisher","first-page":"28","DOI":"10.1016\/j.ijsu.2016.08.018","article-title":"Efficacy of single anastomosis sleeve ileal (SASI) bypass for type-2 diabetic morbid obese patients: gastric bipartition, a novel metabolic surgery procedure: a retrospective cohort study","volume":"34","author":"Mahdy","year":"2016","journal-title":"Int J Surg"},{"key":"2026090214044443100_ref2","doi-asserted-by":"publisher","first-page":"1536","DOI":"10.1007\/s00464-025-12421-w","article-title":"Single anastomosis sleeve ileal (SASI) bypass outcomes and complications: single-arm meta-analysis","volume":"40","author":"Oliveira","year":"2026","journal-title":"Surg 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does the duodenal pathway matter in ileal-level single-anastomosis surgery?","volume":"36","author":"Noel","year":"2026","journal-title":"J Laparoendosc Adv Surg Tech"},{"key":"2026090214044443100_ref9","doi-asserted-by":"publisher","first-page":"5500","DOI":"10.1007\/s11695-021-05756-5","article-title":"Sleeve gastrectomy with Braun anastomosis transit bipartition (B-TB): a potential midway between single anastomosis and Roux-en-Y transit bipartition","volume":"31","author":"Widjaja","year":"2021","journal-title":"Obes Surg"},{"key":"2026090214044443100_ref10","doi-asserted-by":"publisher","first-page":"575","DOI":"10.2147\/DMSO.S295162","article-title":"Revisional surgeries of laparoscopic sleeve gastrectomy","volume":"14","author":"Li","year":"2021","journal-title":"Diabetes Metab Syndr Obes"},{"key":"2026090214044443100_ref11","doi-asserted-by":"publisher","first-page":"1439","DOI":"10.1007\/s11695-019-03752-4","article-title":"Treating severe GERD and obesity with a sleeve 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