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Routine surveillance endoscopy at one year may detect asymptomatic limited ulcers and, thus, prevent ulcer-related complications. In this video clip, we show simple tips to perform RYGB in an incident of liver cirrhosis, with a consider common pitfalls. The main dangers continue to be perioperative bleeding due to portal hypertension and impaired coagulation, as well as the decompensation regarding the cirrhosis. A careful preoperative nutritional and hepatological analysis is necessary because the p