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Effect of circular staple line buttressing material on gastrojejunostomy failure in laparoscopic Roux-en-Y gastric bypass.
Surg Obes Relat Dis. 2010 Jan-Feb; 6(1):64-7.SO

Abstract

BACKGROUND

To determine the effect of bovine pericardium strip (BPS) reinforcement of the circular stapler on the gastrojejunostomy leak rates and staple line failure after laparoscopic Roux-en-Y gastric bypass (LRYGB) at a university hospital in the United States. Gastrojejunostomy leak after LRYGB is a devastating complication. Various techniques, including buttressing the gastrojejunostomy staple line with biomaterial, have been used in an effort to minimize leaks.

METHODS

A total of 350 consecutive patients underwent LRYGB without staple line buttressing. After this initial experience, BPS reinforcement of the gastrojejunostomy was conducted in 81 consecutive patients. BPS reinforcement was not used for the final 69 consecutive patients in this 500 patient series. Circular staple line failures (intraoperative immediate and complete failure of the anastomosis) and leaks were evaluated retrospectively.

RESULTS

Three leaks (and no intraoperative staple line failures) occurred in 419 patients without BPS buttressing, all in the first 100 cases of our experience, and 3 leaks and an anastomotic staple line failure occurred in the 81 patients with BPS buttressing (.7% versus 4.9%, P = .02). The body mass index and other potential leak risk factors did not differ between the 2 groups.

CONCLUSION

In our experience, buttressing of the circular staple line with BPS during LRYGB was associated with an increased staple line adverse event rate. BPS buttressing of the gastrointestinal circular staple lines should be used with caution.

Authors+Show Affiliations

University of Wisconsin School of Medicine and Public Health and UW Health Bariatric Surgery Program, USA.No affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

19640800

Citation

Ibele, Anna, et al. "Effect of Circular Staple Line Buttressing Material On Gastrojejunostomy Failure in Laparoscopic Roux-en-Y Gastric Bypass." Surgery for Obesity and Related Diseases : Official Journal of the American Society for Bariatric Surgery, vol. 6, no. 1, 2010, pp. 64-7.
Ibele A, Garren M, Gould J. Effect of circular staple line buttressing material on gastrojejunostomy failure in laparoscopic Roux-en-Y gastric bypass. Surg Obes Relat Dis. 2010;6(1):64-7.
Ibele, A., Garren, M., & Gould, J. (2010). Effect of circular staple line buttressing material on gastrojejunostomy failure in laparoscopic Roux-en-Y gastric bypass. Surgery for Obesity and Related Diseases : Official Journal of the American Society for Bariatric Surgery, 6(1), 64-7. https://doi.org/10.1016/j.soard.2009.05.006
Ibele A, Garren M, Gould J. Effect of Circular Staple Line Buttressing Material On Gastrojejunostomy Failure in Laparoscopic Roux-en-Y Gastric Bypass. Surg Obes Relat Dis. 2010 Jan-Feb;6(1):64-7. PubMed PMID: 19640800.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Effect of circular staple line buttressing material on gastrojejunostomy failure in laparoscopic Roux-en-Y gastric bypass. AU - Ibele,Anna, AU - Garren,Michael, AU - Gould,Jon, Y1 - 2009/06/23/ PY - 2009/04/07/received PY - 2009/04/10/revised PY - 2009/05/13/accepted PY - 2009/7/31/entrez PY - 2009/7/31/pubmed PY - 2010/6/2/medline SP - 64 EP - 7 JF - Surgery for obesity and related diseases : official journal of the American Society for Bariatric Surgery JO - Surg Obes Relat Dis VL - 6 IS - 1 N2 - BACKGROUND: To determine the effect of bovine pericardium strip (BPS) reinforcement of the circular stapler on the gastrojejunostomy leak rates and staple line failure after laparoscopic Roux-en-Y gastric bypass (LRYGB) at a university hospital in the United States. Gastrojejunostomy leak after LRYGB is a devastating complication. Various techniques, including buttressing the gastrojejunostomy staple line with biomaterial, have been used in an effort to minimize leaks. METHODS: A total of 350 consecutive patients underwent LRYGB without staple line buttressing. After this initial experience, BPS reinforcement of the gastrojejunostomy was conducted in 81 consecutive patients. BPS reinforcement was not used for the final 69 consecutive patients in this 500 patient series. Circular staple line failures (intraoperative immediate and complete failure of the anastomosis) and leaks were evaluated retrospectively. RESULTS: Three leaks (and no intraoperative staple line failures) occurred in 419 patients without BPS buttressing, all in the first 100 cases of our experience, and 3 leaks and an anastomotic staple line failure occurred in the 81 patients with BPS buttressing (.7% versus 4.9%, P = .02). The body mass index and other potential leak risk factors did not differ between the 2 groups. CONCLUSION: In our experience, buttressing of the circular staple line with BPS during LRYGB was associated with an increased staple line adverse event rate. BPS buttressing of the gastrointestinal circular staple lines should be used with caution. SN - 1878-7533 UR - https://www.unboundmedicine.com/medline/citation/19640800/Effect_of_circular_staple_line_buttressing_material_on_gastrojejunostomy_failure_in_laparoscopic_Roux_en_Y_gastric_bypass_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1550-7289(09)00491-2 DB - PRIME DP - Unbound Medicine ER -