Gastric partitioning procedures utilized in bariatric surgery, which completely segment or transect the stomach, have the disadvantage of preventing direct access to the excluded stomach for evaluation of possible pathologic changes or the management of such diseases as peptic ulcer. Retrograde endoscopy is not possible where the combined length of the efferent jejunal limb and proximal jejunum exceeds that of the excluded stomach, and their adaptation to allow direct percutaneous endoscopy are described.
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