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Use of fibrin glue in bariatric surgery: analysis of complications after laparoscopic sleeve gastrectomy on 450 consecutive patients

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Abstract

Laparoscopic Sleeve Gastrectomy (LSG) is one of the most performed surgical procedures in bariatric surgery. Staple line leak and bleeding are by far the two most feared complications after LSG. In this study, we retrospectively compared the efficacy of Fibrin Glue in preventing staple line leak and bleeding. From September 2019 to January 2020, 450 obese patients underwent elective LSG and were placed into groups with Fibrin Glue reinforcement (Group A) or without Fibrin Glue reinforcement (Group B). Primary endpoints were postoperative staple line leak and bleeding; while, secondary endpoints were reintervention rate, total operative time and mortality. Mean Body Mass Index (BMI) was 45.4 ± 7.9 kg/m2 (range: 35.1–81.8). Mean age was 43.3 ± 11.8 years (range: 18–65). No intraoperative complications or conversion to laparotomy were reported. Mean operative time was comparable between the groups (48 ± 18 min in Group A vs 48 ± 14 min in Group B; p > 0.05). No decrease in overall postoperative complications was found in Group A (5.1% vs 7.0%; p > 0.05), but after stratification according to Clavien–Dindo classification, we found a higher rate of Grade II (0.0% vs 1.6%; p < 0.05) and Grade IIIb (0.0% vs 1%; p < 0.05) complications in group B. Our study showed that Fibrin Glue as a reinforcement method during LSG is a reliable tool, without affecting the operative time of surgery and mortality. A significant reduction in complications (Clavien–Dindo grade II and grade IIIb) was observed in patients undergoing LSG with Fibrin Glue.

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Data that support the findings of this study are available from the corresponding author upon reasonable request.

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The research was not supported by any funding.

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Authors and Affiliations

  1. General and Oncologic Surgery Department–Centre of Bariatric Surgery, San Marco Hospital - Gruppo San Donato, Corso Europa, 7, 24040, Zingonia, BG, Italy

    Matteo Uccelli, Simone Targa, Giovanni Carlo Cesana, Alberto Oldani, Francesca Ciccarese, Riccardo Giorgi, Stefano Maria De Carli & Stefano Olmi

  2. University of Milan and Vita-Salute University San Raffaele, Milan, Italy

    Stefano Olmi

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  1. Matteo Uccelli
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  2. Simone Targa
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  3. Giovanni Carlo Cesana
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  4. Alberto Oldani
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  5. Francesca Ciccarese
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  6. Riccardo Giorgi
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  7. Stefano Maria De Carli
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  8. Stefano Olmi
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Contributions

Matteo Uccelli contributed as principal investigator and expert bariatric surgeon. He contributed to the final draft of the work, Simone Targa contributed as investigator. He contributed to the final draft of the work. Giovanni Carlo Cesana contributed as investigator and expert bariatric surgeon. Alberto Oldani contributed as investigator and he has contributed to the final draft of the work. Francesca Ciccarese contributed as investigator and expert bariatric surgeon. Riccardo Giorgi contributed as investigator and he has contributed to the final draft of the work. Stefano Maria DE Carli contributed as investigator. Stefano Olmi contributed as senior author, principal investigator and expert bariatric surgeon.

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Correspondence to Simone Targa.

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Uccelli, M., Targa, S., Cesana, G.C. et al. Use of fibrin glue in bariatric surgery: analysis of complications after laparoscopic sleeve gastrectomy on 450 consecutive patients. Updates Surg 73, 305–311 (2021). https://doi.org/10.1007/s13304-020-00865-9

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