Faculty Collaboration Database

The impact of circular stapler diameter on the incidence of gastrojejunostomy stenosis and weight loss following laparoscopic Roux-en-Y gastric bypass. Surg Endosc 2006 Jul;20(7):1017-20

Date

06/10/2006

Pubmed ID

16763928

DOI

10.1007/s00464-005-0207-5

Scopus ID

2-s2.0-33746059359 (requires institutional sign-in at Scopus site)   70 Citations

Abstract

BACKGROUND: Gastrojejunostomy stenosis after laparoscopic Roux-en-Y gastric bypass is a common occurrence. The incidence varies widely among reported series. We evaluated the impact of circular stapler size on the rate of stenosis and weight loss.

METHODS: Our initial technique utilized a 21-mm circular stapler to construct the gastrojejunostomy. We switched to a 25-mm stapler after a large preliminary experience. Stenosis was confirmed by endoscopy in patients complaining of the inability to eat or excessive vomiting, and was defined as a gastrojejunostomy diameter less than that of a therapeutic endoscope (11-mm).

RESULTS: Stenosis occurred in 23 of 145 patients (15.9%) with a 21-mm gastrojejunostomy. Five of 81 patients with a 25-mm circular stapled anastomosis have developed a stenosis (6.2%, p = 0.03). Weight loss was similar for each sized stapler at 6 and 12 months.

CONCLUSIONS: The use of a 25-mm circular stapler in laparoscopic gastric bypass is preferable to a 21-mm stapler. The larger stapler is associated with a significantly decreased incidence of gastrojejunostomy stenosis without compromising early weight loss.

Author List

Gould JC, Garren M, Boll V, Starling J

Author

Jon Gould MD Chief, Professor in the Surgery department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Constriction, Pathologic
Equipment Design
Female
Gastric Bypass
Gastrostomy
Humans
Incidence
Jejunostomy
Laparoscopy
Male
Middle Aged
Surgical Staplers
Weight Loss