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Reinforcing gastric staple-lines with bovine pericardial strips may decrease the likelihood of gastric leak after laparoscopic Roux-en-Y gastric bypass.
Obes Surg. 2003 Feb; 13(1):37-44.OS

Abstract

BACKGROUND

Staple-line leakage is a potentially devastating complication of Roux-en-Y gastric bypass (RYGBP). Bovine pericardial strips (BPS) have been used to reinforce staple-lines in pulmonary resections and have been shown to decrease air-leaks. This study examined the use of BPS to decrease gastric staple-line leaks.

METHODS

250 consecutive patients undergoing laparoscopic RYGBP had BPS used for the gastric pouch. Ease of use, operative complications, and visual bleeding were recorded. In addition, the postoperative leak rate was compared to 100 consecutive patients operated on prior to the study when BPS was not used.

RESULTS

Patient characteristics were the same for both groups and comparable with most published data. With the use of BPS, there were no operative complications and no meaningful increase in operating time. BPS reinforced staple-lines had no visual bleeding. In the 100 cases without BPS, there were 2 staple-line leaks (2%) both of which required emergency exploration. One additional patient was subsequently found to have a gastrogastric fistula. In the 250 patients who had BPS-reinforced staple-lines, there were no acute leaks. Three patients were subsequently found to have gastrogastric fistula. None required emergency surgery.

CONCLUSION

In this non-randomized trial, BPS were found to be easy and safe to use. In addition, staple-line hemorrhage was essentially non-existent. Although the reduction in gastric staple-line leak rate may also be attributed to learning curve, there were no acute leaks in 250 patients with BPS, which is below the published norms.

Authors+Show Affiliations

Department of Surgery and Obesity Consult Center, Centerfor Minimally Invasive Obesity Surgery Tufts-New England Medical Center, Boston, MA 02111, USA. sshikora@lifespan.orgNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

12630611

Citation

Shikora, Scott A., et al. "Reinforcing Gastric Staple-lines With Bovine Pericardial Strips May Decrease the Likelihood of Gastric Leak After Laparoscopic Roux-en-Y Gastric Bypass." Obesity Surgery, vol. 13, no. 1, 2003, pp. 37-44.
Shikora SA, Kim JJ, Tarnoff ME. Reinforcing gastric staple-lines with bovine pericardial strips may decrease the likelihood of gastric leak after laparoscopic Roux-en-Y gastric bypass. Obes Surg. 2003;13(1):37-44.
Shikora, S. A., Kim, J. J., & Tarnoff, M. E. (2003). Reinforcing gastric staple-lines with bovine pericardial strips may decrease the likelihood of gastric leak after laparoscopic Roux-en-Y gastric bypass. Obesity Surgery, 13(1), 37-44.
Shikora SA, Kim JJ, Tarnoff ME. Reinforcing Gastric Staple-lines With Bovine Pericardial Strips May Decrease the Likelihood of Gastric Leak After Laparoscopic Roux-en-Y Gastric Bypass. Obes Surg. 2003;13(1):37-44. PubMed PMID: 12630611.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Reinforcing gastric staple-lines with bovine pericardial strips may decrease the likelihood of gastric leak after laparoscopic Roux-en-Y gastric bypass. AU - Shikora,Scott A, AU - Kim,Julie J, AU - Tarnoff,Michael E, PY - 2003/3/13/pubmed PY - 2003/6/5/medline PY - 2003/3/13/entrez SP - 37 EP - 44 JF - Obesity surgery JO - Obes Surg VL - 13 IS - 1 N2 - BACKGROUND: Staple-line leakage is a potentially devastating complication of Roux-en-Y gastric bypass (RYGBP). Bovine pericardial strips (BPS) have been used to reinforce staple-lines in pulmonary resections and have been shown to decrease air-leaks. This study examined the use of BPS to decrease gastric staple-line leaks. METHODS: 250 consecutive patients undergoing laparoscopic RYGBP had BPS used for the gastric pouch. Ease of use, operative complications, and visual bleeding were recorded. In addition, the postoperative leak rate was compared to 100 consecutive patients operated on prior to the study when BPS was not used. RESULTS: Patient characteristics were the same for both groups and comparable with most published data. With the use of BPS, there were no operative complications and no meaningful increase in operating time. BPS reinforced staple-lines had no visual bleeding. In the 100 cases without BPS, there were 2 staple-line leaks (2%) both of which required emergency exploration. One additional patient was subsequently found to have a gastrogastric fistula. In the 250 patients who had BPS-reinforced staple-lines, there were no acute leaks. Three patients were subsequently found to have gastrogastric fistula. None required emergency surgery. CONCLUSION: In this non-randomized trial, BPS were found to be easy and safe to use. In addition, staple-line hemorrhage was essentially non-existent. Although the reduction in gastric staple-line leak rate may also be attributed to learning curve, there were no acute leaks in 250 patients with BPS, which is below the published norms. SN - 0960-8923 UR - https://www.unboundmedicine.com/medline/citation/12630611/Reinforcing_gastric_staple_lines_with_bovine_pericardial_strips_may_decrease_the_likelihood_of_gastric_leak_after_laparoscopic_Roux_en_Y_gastric_bypass_ L2 - https://dx.doi.org/10.1381/096089203321136566 DB - PRIME DP - Unbound Medicine ER -