Impact of gastrojejunostomy diameter on long-term weight loss following laparoscopic gastric bypass: a follow-up study. Surg Endosc 2011 Jul;25(7):2164-7
Date
12/25/2010Pubmed ID
21184107Pubmed Central ID
PMC4806845DOI
10.1007/s00464-010-1516-xScopus ID
2-s2.0-79960408864 (requires institutional sign-in at Scopus site) 20 CitationsAbstract
BACKGROUND: Stenosis of the gastrojejunostomy after laparoscopic Roux-en-Y gastric bypass is a common occurrence. We have previously presented data demonstrating that the use of a 25-mm circular stapler results in a decreased incidence of stenosis compared to the results of a 21-mm circular stapler (6.2 vs. 15.9%, P=0.03). One potential drawback of the larger-diameter stapler is the possibility for impaired long-term weight loss due to decreased restriction. We sought to determine the impact of circular stapler diameter on excess weight loss up to 5 years after surgery.
METHODS: Our initial technique for creating the gastrojejunostomy after laparoscopic gastric bypass involved the transgastric passage of a 21-mm circular stapler anvil (group 1). After a large initial experience, we switched to a 25-mm circular stapler (group 2). Follow-up data were entered prospectively into a computer database. Weight loss was recorded as percent of excess weight lost. Only patients with follow-up beyond 3 years postoperatively were eligible for inclusion.
RESULTS: Group 1 consisted of 145 consecutive patients and group 2 consisted of 116 consecutive patients. There was no significant difference in weight loss between the groups at 3 (66.1 vs. 65.2%, P=0.76, n=134), 4 (66.4 vs. 58.6%, P=0.1, n=66), and 5 years after gastric bypass (62.7 vs. 57.5%, P=0.24, n=75).
CONCLUSIONS: The use of a 25-mm circular stapler in laparoscopic gastric bypass operations instead of a 21-mm stapler does not result in significantly different long-term weight loss. The 25-mm stapler is preferred with our technique.
Author List
Smith C, Garren M, Gould JAuthor
Jon Gould MD Chief, Professor in the Surgery department at Medical College of WisconsinMESH terms used to index this publication - Major topics in bold
AdultChi-Square Distribution
Constriction, Pathologic
Female
Follow-Up Studies
Gastric Bypass
Gastrostomy
Humans
Jejunostomy
Male
Middle Aged
Surgical Staplers
Treatment Outcome
Weight Loss