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Linear stapled gastrojejunostomy results in fewer strictures compared to circular stapled gastrojejunostomy in laparoscopic gastric bypass surgery

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Abstract

Purpose

Currently, there are two laparoscopic stapling techniques to perform the gastrojejunostomy in gastric bypass surgery: the linear stapling and circular stapling techniques. The aim of the study was to compare the two techniques regarding postoperative morbidity and weight loss at an accredited bariatric reference center in Switzerland.

Methods

We compared two consecutive cohorts at a single institution between November 2012 and June 2014 undergoing laparoscopic gastric bypass surgery. The frequency of complications and weight loss at 1 year was assessed in 109 patients with the 21-mm circular stapling technique (CSA) and 134 patients with the linear stapling technique (LSA).

Results

Postoperative complications were more frequent in the CSA group with 23.9 versus 4.5% in the LSA group (p = <0.0001). The main difference was the frequency of strictures, which occurred in 15.6% in the CSA group versus 0% in the LSA group. As a result, endoscopic dilation was required at least once in 15 patients. There was no statistically significant difference in percentage of excessive weight loss (EWL) in both groups; EWL was 74% in the CSA group and 73% in the LSA group (p = 0.68).

Conclusion

Linear stapled laparoscopic gastric bypass had fewer stenotic strictures with similar weight loss at 1 year compared to circular stapling technique.

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Author information

Authors and Affiliations

  1. Klinik für Allgemein-, Viszeral- und Transplantationschirurgie, Kantonsspital St. Gallen, Rorschacherstrasse 95, 9007, St. Gallen, Switzerland

    Larissa Vines, Thomas Frick & Marc Schiesser

  2. Klinik für Endokrinologie, Kantonsspital St. Gallen, Rorschacherstrasse 95, 9007, St. Gallen, Switzerland

    Stefan Aczél

  3. Ostschweizer Kinderspital, St. Gallen, Claudiusstrasse 6, 9006, St. Gallen, Switzerland

    Dagmar L’Allemand

  4. Klinik für Gastroenterologie und Hepatologie, Kantonsspital St. Gallen, Rorschacherstrasse 95, 9007, St. Gallen, Switzerland

    Jan Borovicka

Authors
  1. Larissa Vines
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  2. Thomas Frick
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  3. Stefan Aczél
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  4. Dagmar L’Allemand
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  5. Jan Borovicka
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  6. Marc Schiesser
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Contributions

Study conception and design: Marc Schiesser; acquisition of data: Marc Schiesser and Thomas Frick; analysis and interpretation of data: Marc Schiesser and Larissa Vines; Drafting of manuscript: Larissa Vines; and critical revision of manuscript: Marc Schiesser, Stefan Aczel, Dagmar L’Allemand, and Jan Borovicka.

Corresponding author

Correspondence to Marc Schiesser.

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Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in the study were in accordance with the ethical standard of our institution and with the 1964 Helsinki declaration and its later amendments.

Informed consent

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

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Vines, L., Frick, T., Aczél, S. et al. Linear stapled gastrojejunostomy results in fewer strictures compared to circular stapled gastrojejunostomy in laparoscopic gastric bypass surgery. Langenbecks Arch Surg 402, 911–916 (2017). https://doi.org/10.1007/s00423-017-1598-1

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  • DOI: https://doi.org/10.1007/s00423-017-1598-1

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