Abstract
Background
Although the published data have clearly related the size of the gastrojejunostomy
anastomosis to the subsequent likelihood of a stricture, a correlation between the
anastomosis size and postoperative weight loss has not previously been described.
Methods
A retrospective comparison was made of 124 anastomoses accomplished with the 21-mm
circular stapler followed by 100 anastomoses created with the 45-mm linear stapler
technique at 6 community hospitals in Southern California. Age, gender, and preoperative
weights were not significantly different between the 2 groups. The precise size of
the anastomosis created using the linear stapler technique could not be determined,
but it was calculated to be slightly larger than a 25-mm circular stapled anastomosis.
Both weight loss trends were fit with a 1-phase exponential nonlinear regression analysis.
The resulting curves were compared using an F test. A 1-tailed t test was also used to compare the weight loss at 12 months.
Results
An F test comparison of the exponential weight loss curves generated by the 2 anastomosis
groups showed a significantly different trend in weight loss (P <.001). A 1-tailed t test comparison of the 2 groups at 12 months revealed significantly different results
(p <.0025).
Conclusion
The results of this study show that the size of the anastomosis has a clear correlation
with postoperative weight loss. A smaller opening results in significantly more weight
loss.
Keywords
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References
- Critical determinants of a successful gastric bypass: reservoir versus stoma.Am J Gastroenterol. 1982; 77: 464-466
- Early results after laparoscopic gastric bypass: EEA vs GIA stapled gastrojejunal anastomosis.Obes Surg. 2003; 13: 355-359
- Incidence and outcome of anastomotic stricture after laparoscopic gastric bypass.Gastrointest Surg. 2003; 7: 997-1003
- Comparison of 21 vs. 25 mm gastrojejunostomy in the gastric bypass procedure—early results.Obes Surg. 2000; 10: 540-542
- Stricture rates after circular stapled vs. linear stapled gastrojejunostomy for laparoscopic gastric bypass.Eur Surg. 2006; 38 (405–10): 6
Article info
Publication history
Published online: September 05, 2008
Accepted:
August 26,
2008
Received in revised form:
July 25,
2008
Received:
April 24,
2008
Footnotes
Reprints not available from the authors.
Identification
Copyright
© 2009 American Society for Metabolic and Bariatric Surgery. Published by Elsevier Inc. All rights reserved.
