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Following laparoscopic Roux-en-Y gastric bypass (RYGB), complications such as marginal ulceration and bleeding may occur.
The technique of
gastrojejunal anastomosis (GJA) has a substantial impact on the rate of
formation of marginal ulceration. A 25-mm end-to-end anastomosis (EEA) stapler
tends to have increased rates of upper endoscopy and marginal ulceration.
Following
laparoscopic Roux-en-Y gastric bypass (RYGB), complications such as marginal
ulceration and bleeding may occur. This study aimed to explore the
postoperative occurrence of marginal ulceration and anastomotic bleeding
with the GJA techniques.
In this study, three
techniques for carrying out GJA were compared: (i) 25-mm EEA stapler, (ii)
linear stapler (LS), and (iii) robotic hand-sewn (RHS). The electronic health
records for all the individuals who underwent upper endoscopy (also known as
esophagogastroduodenoscopy [EGD]) after RYGB were queried. The charts were
retrospectively reviewed for the type of GJA, endoscopic interventions, complications,
smoking, and NSAID usage.
Out of total 1112 RYGBs carried out, the GJA was created utilizing an EEA, LS, or RHS technique in 58.6%, 33.6%, and 7.7% of patients, respectively. Notably, 17.4% were found to have an EGD (19.9% EEA, 13.9% LS, and 14.0% RHS). The marginal ulceration occurrence was 7.3%.
The rates of EGD and marginal ulceration were considerably greater following EEA vs. LS GJA. The bleeding rate was 1.5%. The marginal ulceration within 90 days of RYGB, NSAID use, and cigarette use for the EEA, LS, and RHS group are shown in Table 1:
A
GJA via a 25mm EEA stapler tends to have
elevated rates of EGD and marginal ulceration after gastric bypass surgery.
Obesity surgery
Impacts of Gastrojejunal Anastomotic Technique on Rates of Marginal Ulcer Formation and Anastomotic Bleeding Following Roux-en-Y Gastric Bypass
Naresh Sundaresan et al.
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