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

Fundus Wall Thickness and Leaks

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A Correction to this article was published on 05 August 2019

This article has been updated

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.

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Change history

  • 05 August 2019

    There is an error in the published article. One patient���s gender was mistaken; it has been changed from female to male. Thus, the number of male and female patients in Tables��1 and 2, and the median and p value in Table 2 are incorrect.

  • 05 August 2019

    There is an error in the published article. One patient���s gender was mistaken; it has been changed from female to male. Thus, the number of male and female patients in Tables��1 and 2, and the median and p value in Table 2 are incorrect.

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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.

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Authors and Affiliations

  1. Department of General, Visceral, Vascular and Bariatric Surgery, Klinikum Nordstadt, Haltenhoffstr. 41, 30167, Hannover, Germany

    Clara Boeker, Julian Mall, Christian Reetz & Kamil Yamac

  2. Department of Pathology, Klinikum Nordstadt, Haltenhoffstr. 41, 30167, Hannover, Germany

    Ludwig Wilkens

  3. Department of General, Visceral and Children Surgery, SRH Wald-Klinikum Gera, Str. d. Friedens 122, 07548, Gera, Germany

    Christine Stroh

  4. Department of Surgery, Herzogin Elisabeth Hospital, Leipziger Straße 24, 38124, Braunschweig, Germany

    Hinrich Koehler

Authors
  1. Clara Boeker
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  2. Julian Mall
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  3. Christian Reetz
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  4. Kamil Yamac
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  5. Ludwig Wilkens
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  6. Christine Stroh
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  7. Hinrich Koehler
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Corresponding author

Correspondence to Clara Boeker.

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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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Boeker, C., Mall, J., Reetz, C. et al. Laparoscopic Sleeve Gastrectomy: Investigation of Fundus Wall Thickness and Staple Height—an Observational Cohort Study. OBES SURG 27, 3209–3214 (2017). https://doi.org/10.1007/s11695-017-2755-x

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  • DOI: https://doi.org/10.1007/s11695-017-2755-x

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