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Linear Stapler Technique May Be Safer than Circular in Gastrojejunal Anastomosis for Laparoscopic Roux-en-Y Gastric Bypass: A Meta-analysis of Comparative Studies

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Abstract

The technique of choice for gastrojejunostomy (GJ) during laparoscopic Roux-en-Y gastric bypass (LRYGB) for morbid obesity is controversial. We performed a meta-analysis comparing linear versus circular stapler technique to evaluate this issue. A systematic literature search was performed. Primary outcomes were gastrojejunal leak and stricture. Secondary outcomes were operative time, length of hospital stay, post-operative bleeding, wound infection, marginal ulcers and estimated weight loss. Eight studies involving 1,321 patients were retrieved and included in the present study. A significantly decreased risk of GJ stricture was observed after using linear versus circular stapler (RR, 0.34; 95% CI, 0.12–0.93; p = 0.04). Wound infection risk (RR, 0.38; 95% CI, 0.22–0.67; p = 0.0008) and operative time (MD, −24.18; 95% CI, −35.31, −13.05; p < 0.0001) were significantly reduced by using linear stapling. No significant differences were observed in the other outcome end-points. The use of the linear stapler compared with circular stapler for GJ during LRYGB for morbid obesity may be associated with a reduced risk of anastomosis stricture and wound infection, as well as with a shorter operative time.

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Authors and Affiliations

  1. Department of Surgery, Turku University Hospital, OS 299, PL 52, 20521, Turku, Finland

    Salvatore Giordano & Paulina Salminen

  2. Department of Surgery, Vaasa Central Hospital, Vaasa, Finland

    Salvatore Giordano & Mikael Victorzon

  3. Department of Surgery, Oulu University Hospital, Oulu, Finland

    Fausto Biancari

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  1. Salvatore Giordano
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  2. Paulina Salminen
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  3. Fausto Biancari
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  4. Mikael Victorzon
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Correspondence to Salvatore Giordano.

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Giordano, S., Salminen, P., Biancari, F. et al. Linear Stapler Technique May Be Safer than Circular in Gastrojejunal Anastomosis for Laparoscopic Roux-en-Y Gastric Bypass: A Meta-analysis of Comparative Studies. OBES SURG 21, 1958–1964 (2011). https://doi.org/10.1007/s11695-011-0520-0

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