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Obesity Surgery

, Volume 27, Issue 12, pp 3209–3214 | Cite as

Laparoscopic Sleeve Gastrectomy: Investigation of Fundus Wall Thickness and Staple Height—an Observational Cohort Study

Fundus Wall Thickness and Leaks
  • Clara BoekerEmail author
  • Julian Mall
  • Christian Reetz
  • Kamil Yamac
  • Ludwig Wilkens
  • Christine Stroh
  • Hinrich Koehler
Original Contributions

Abstract

Background

Staple line leakage is a well-known complication after laparoscopic sleeve gastrectomy (LSG). Gastric wall thickness and the staple height may be determining factors for the occurrence of insufficiencies. To investigate this problem, an observational cohort study was carried out. Investigation concentrated on the gastroesophageal junction close to the angle of His, since this area is at highest risk for a leakage.

Methods

Fundus wall thickness of 141 specimens after LSG was measured by light microscopy at a predetermined location by a blinded pathologist. Furthermore, fundus wall thickness was compared with demographic data, clinical outcome, and the rate of insufficiencies.

Results

One hundred forty-one patients, 38 male and 103 female undergoing LSG, between January 2014 and July 2015 were included in the study. Male gender was associated with thicker gastric fundus wall. Overall leak rate was 2.1% (3/141). Median wall thickness of the 3 patients with detected leaks in the study group was thinner compared to the non-leak group (2810 vs. 3249 μm, respectively).

Discussion/Conclusion

Only male gender correlated with higher wall thickness of the fundus. The fact that all three patients who developed a leak were female, and the fundus of female patients as well as those of the leak group was thinner, indicates that wall thickness may have an impact on the rate of staple line leakage. Further studies with larger patient cohorts are needed.

Keywords

Sleeve gastrectomy Leak Staple height Wall thickness Risk factors 

Notes

Acknowledgments

We would like to acknowledge the team of the Department of General, Visceral, Vascular and Bariatric Surgery and the operating room staff at Klinikum Nordstadt and the Department of Pathology of the Klinikum Nordstadt for their assistance and help.

Compliance with Ethical Standards

Conflict of Interest

The authors declare that there is no conflict of interest.

Ethics

All procedures and collection of patient data followed the ethical standards of the institutional and/or national research committee and the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

Consent

Informed consent was obtained from all individual participants included in the study.

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Copyright information

© Springer Science+Business Media New York 2017

Authors and Affiliations

  1. 1.Department of General, Visceral, Vascular and Bariatric SurgeryKlinikum NordstadtHannoverGermany
  2. 2.Department of PathologyKlinikum NordstadtHannoverGermany
  3. 3.Department of General, Visceral and Children SurgerySRH Wald-Klinikum GeraGeraGermany
  4. 4.Department of SurgeryHerzogin Elisabeth HospitalBraunschweigGermany

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