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Routine surveillance endoscopy at 1 year may identify asymptomatic marginal ulcers and, thus, prevent ulcer-related complications. In this video clip, we reveal simple tips to perform RYGB in an incident of liver cirrhosis, with a consider common problems. The main risks stay perioperative bleeding as a result of portal hypertension and impaired coagulation, as well as the decompensation associated with the cirrhosis. A careful preoperative nutritional and