Linear vs. circular-stapled gastrojejunostomy in Roux-en-Y gastric bypass. Surg Endosc 2019 Dec;33(12):4098-4101
Date
02/26/2019Pubmed ID
30805785DOI
10.1007/s00464-019-06712-2Scopus ID
2-s2.0-85062153988 (requires institutional sign-in at Scopus site) 13 CitationsAbstract
BACKGROUND: Various surgical techniques exist to create the gastrojejunostomy during laparoscopic Roux-en-Y gastric bypass (LRYGB). Linear-stapled anastomosis (LSA) and circular-stapled anastomosis (CSA) are two commonly employed techniques. We hypothesized that CSA is associated with an increased rate of surgical site infection (SSI) and gastrojejunostomy stenosis when compared to LSA.
METHODS: This study is a retrospective review of patients who underwent LRYGB for morbid obesity at a single institution between 2012 and 2016. Three bariatric surgeons contributed patients to this series. Clinical information and perioperative outcomes were collected through 90 days after surgery.
RESULTS: 171 patients met the inclusion criteria. Two patients did not complete 90-day follow-up and were excluded from the analysis (88 patients CSA, 81 LSA; 99% 90-day follow-up). Patient demographics did not differ between groups. The LSA technique was associated with a significantly reduced rate of SSI (0 (0%) vs. 6 (6.8%), p = 0.02) and stenosis (2 (2.5%) vs. 17 (19.3%), p < 0.01). The CSA technique demonstrated a greater number of endoscopic dilations per stenotic event (1.5 ± 0.8 vs. 1.0 ± 0, p = 0.03).
CONCLUSION: In our experience, a gastrojejunostomy constructed with an LSA technique was associated with a significantly reduced rate of stenosis and SSI compared to the CSA technique. LSA is currently our anastomotic technique of choice in LRYGB.
Author List
Barr AC, Lak KL, Helm MC, Kindel TL, Higgins RM, Gould JCAuthors
Jon Gould MD Chief, Professor in the Surgery department at Medical College of WisconsinRana Higgins MD Associate Professor in the Surgery department at Medical College of Wisconsin
Tammy Lyn Kindel MD, PhD Associate Professor in the Surgery department at Medical College of Wisconsin
Kathleen L. Lak MD Associate Professor in the Surgery department at Medical College of Wisconsin
MESH terms used to index this publication - Major topics in bold
AdultAnastomosis, Surgical
Female
Gastric Bypass
Humans
Male
Middle Aged
Obesity, Morbid
Postoperative Complications
Retrospective Studies
Surgical Stapling
Treatment Outcome