Surgical Endoscopy

, Volume 25, Issue 7, pp 2164–2167

Impact of gastrojejunostomy diameter on long-term weight loss following laparoscopic gastric bypass: a follow-up study

Article

DOI: 10.1007/s00464-010-1516-x

Cite this article as:
Smith, C., Garren, M. & Gould, J. Surg Endosc (2011) 25: 2164. doi:10.1007/s00464-010-1516-x

Abstract

Background

Stenosis of the gastrojejunostomy after laparoscopic Roux-en-Y gastric bypass is a common occurrence. We have previously presented data demonstrating that the use of a 25-mm circular stapler results in a decreased incidence of stenosis compared to the results of a 21-mm circular stapler (6.2 vs. 15.9%, P = 0.03). One potential drawback of the larger-diameter stapler is the possibility for impaired long-term weight loss due to decreased restriction. We sought to determine the impact of circular stapler diameter on excess weight loss up to 5 years after surgery.

Methods

Our initial technique for creating the gastrojejunostomy after laparoscopic gastric bypass involved the transgastric passage of a 21-mm circular stapler anvil (group 1). After a large initial experience, we switched to a 25-mm circular stapler (group 2). Follow-up data were entered prospectively into a computer database. Weight loss was recorded as percent of excess weight lost. Only patients with follow-up beyond 3 years postoperatively were eligible for inclusion.

Results

Group 1 consisted of 145 consecutive patients and group 2 consisted of 116 consecutive patients. There was no significant difference in weight loss between the groups at 3 (66.1 vs. 65.2%, P = 0.76, n = 134), 4 (66.4 vs. 58.6%, P = 0.1, n = 66), and 5 years after gastric bypass (62.7 vs. 57.5%, P = 0.24, n = 75).

Conclusions

The use of a 25-mm circular stapler in laparoscopic gastric bypass operations instead of a 21-mm stapler does not result in significantly different long-term weight loss. The 25-mm stapler is preferred with our technique.

Keywords

GastrojejunostomyStenosisLaparoscopic gastric bypassWeight loss

Copyright information

© Springer Science+Business Media, LLC 2010

Authors and Affiliations

  1. 1.Department of SurgeryUniversity of Wisconsin School of Medicine and Public HealthMadisonUSA
  2. 2.H4/726 Clinical Science CenterMadisonUSA