Experience with the circular stapler for the gastrojejunostomy in laparoscopic gastric bypass (350 cases).
BACKGROUND
The increased incidence of morbid obesity has resulted in an increase in bariatric surgery. The gastrojejunostomy performed during Roux-en-Y gastric bypass (RYGBP) operations has technical variability with different outcomes and complication-rates immediate postoperatively and at long-term follow-up.


METHODS
Between Jan 2000 and Feb 2005, 350 laparoscopic RYGBP procedures were performed. We present our immediate and follow-up rate of complications with total intraabdominal gastrojejunostomy, performed with the circular stapler.


RESULTS
Complications of gastrojejunostomy were detected in 24 patients (6.8%): 3 anastomotic leaks (0.8%); 6 bleeding (1.7%) immediately postoperatively, and 4 stenoses (1.1%), 10 ulcers (2.8%) and 1 stenosis plus ulcer (0.3%) during long-term follow-up. There was no mortality related to the gastrojejunostomy.


CONCLUSIONS
The gastrojejunostomy with circular stapler is an easily reproducible procedure. The rate of complications has been low. Surgeons who perform laparoscopic RYGBP should have a careful learning curve, and should be aware of the potential complications and their management.
Luján
Juan Antonio
JA
Departamento de Cirugía General Hospital Universitario "Virgen de la Arrixaca", Murcia, Spain. juanlujan@telefonica.net
Frutos
Maria Dolores
MD
Hernández
Quiteria
Q
Cuenca
Jose Ramón
JR
Valero
Graciela
G
Parrilla
Pascual
P
D000293:Adolescent; D000328:Adult; D000368:Aged; D000713:Anastomosis, Roux-en-Y; D005260:Female; D015390:Gastric Bypass / Q000295:instrumentation*; D005763:Gastroenterostomy / Q000295:instrumentation*; D006801:Humans; D007583:Jejunum / Q000601:surgery; D010535:Laparoscopy; D008297:Male; D008875:Middle Aged; D009767:Obesity, Morbid / Q000601:surgery; D011183:Postoperative Complications; D013528:Surgical Staplers