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Size really does matter—role of gastrojejunostomy in postoperative weight loss

Published:September 05, 2008DOI:https://doi.org/10.1016/j.soard.2008.08.020

      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

        • Kirkpatrick J.R.
        • Siegle T.
        Critical determinants of a successful gastric bypass: reservoir versus stoma.
        Am J Gastroenterol. 1982; 77: 464-466
        • Shope T.R.
        • Cooney R.N.
        • McLeod J.
        • Miller C.A.
        • Haluck R.S.
        Early results after laparoscopic gastric bypass: EEA vs GIA stapled gastrojejunal anastomosis.
        Obes Surg. 2003; 13: 355-359
        • Nguyen N.T.
        • Sevens C.M.
        • Wolfe B.M.
        Incidence and outcome of anastomotic stricture after laparoscopic gastric bypass.
        Gastrointest Surg. 2003; 7: 997-1003
        • Stahl R.D.
        • Sherer R.A.
        • Seevers C.E.
        • Johnston D.
        Comparison of 21 vs. 25 mm gastrojejunostomy in the gastric bypass procedure—early results.
        Obes Surg. 2000; 10: 540-542
        • Haughn C.
        • Calic S.
        • Carrodeguas L.
        • Szomstein S.
        • Rosenthal R.
        • Bergamaschi R.
        Stricture rates after circular stapled vs. linear stapled gastrojejunostomy for laparoscopic gastric bypass.
        Eur Surg. 2006; 38 (405–10): 6