title: Experience with the circular stapler for the gastrojejunostomy in laparoscopic gastric bypass (350 cases).
abstract: 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.
authors.affiliation: Departamento de Cirugía General Hospital Universitario "Virgen de la Arrixaca", Murcia, Spain. juanlujan@telefonica.net
authors.forename: Juan Antonio
authors.initials: JA
authors.lastname: Luján
authors.forename: Maria Dolores
authors.initials: MD
authors.lastname: Frutos
authors.forename: Quiteria
authors.initials: Q
authors.lastname: Hernández
authors.forename: Jose Ramón
authors.initials: JR
authors.lastname: Cuenca
authors.forename: Graciela
authors.initials: G
authors.lastname: Valero
authors.forename: Pascual
authors.initials: P
authors.lastname: Parrilla
mesh_terms: 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