Leak Rates after RNY Gastric Bypass

** Strictures stapled 10% and 4% handsewn **
4 stapled group 4% and 6 handsewn 5% needed early reoperation.
1 GJ anastomotic leak 1%

Yikes: Leaks 1/100, Strictures 5-10% and Re-operation 5%!!

If those numbers held in our 6,000 MGB patients:
`600 Strictures
60 Leaks
300 Re-operations
(We did better than that ;-)


Amplify’d from www.ncbi.nlm.nih.gov

Surg Endosc. 2010 Oct 7. [Epub ahead of print]

A comparative study of handsewn versus stapled gastrojejunal anastomosis in laparoscopic Roux-en-Y gastric bypass.

Kravetz AJ, Reddy S, Murtaza G, Yenumula P.

Department of Surgery, Michigan State University, Sparrow Professional Building, 1200 East Michigan Avenue, Ste 655, Lansing, MI, 48912, USA.


BACKGROUND: The two basic techniques available in which to perform the gastrojejunal (GJ) anastomosis during a laparoscopic Roux-en-Y gastric bypass (LRYGBP) are stapled and handsewn. Few outcomes differences have been noted between the two to recommend one as a superior approach. We present our findings in comparison of the two methods.

METHODS: This is a retrospective review of all patients who underwent LRYGBP at a single institution during a 3-year period. The two different techniques that were used were a linear stapled and handsewn anastomosis with an anastomotic diameter of 18 mm. The groups were compared for postoperative complications, including stricture, anastomotic leak, and the need for early reoperation. All patients were followed up for a minimum period of 8 months.

RESULTS: A total of 222 patients were analyzed after excluding 4 patients: 3 for revisional surgery and 1 for conversion to open. There were 99 patients in the stapled group and 123 in the handsewn group. In both groups, patients were predominantly female. The average age was 42.63 in the stapled group and 44.33 in the handsewn group (P = 0.218). Body mass index was 48.23 in the stapled group and 47.91 in the handsewn group (P = 0.733). Stricture rate in the stapled group was 10.1% (10/99) and 4.1% (5/123) in the handsewn group (P = 0.076). Four patients from the stapled group (4.08%) and six from the handsewn group (4.88%) needed early reoperation. One patient in each group had a GJ anastomotic leak (0.9%). There were no deaths.

CONCLUSIONS: The incidence of anastomotic stricture tends to be lower with a handsewn technique with lower operative time. No difference was appreciated in the anastomotic leak or reexploration rate with either technique.

PMID: 20927539 [PubMed – as supplied by publ

Read more at www.ncbi.nlm.nih.gov



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