title: Laparoscopic Roux-en-Y gastric bypass: comparison between hand-sewn and mechanical gastrojejunostomy.
abstract: The laparoscopic Roux-en-Y gastric bypass (LRYGB) is one of the ideal operations in the treatment of morbid obesity. There are several variations in the operation, especially during the construction of the gastrojejunostomy (GJA). From June 2006 to September 2008, 104 consecutive obese patients underwent LRYGB. The procedure was standardized, with the exception of the construction of the GJA, which was linear-stapled in 51 patients and hand-sewn in 53 other patients. A retrospective analysis was performed to compare the procedures. The series comprised 81 women and 23 men with a median age of 44 years, and a median BMI of 46.7 kg/m(2). There was no significant difference between the two groups of patients with respect to age, gender, BMI, ASA, and previously failed bariatric surgery. There was no significant difference between the two groups with respect to mortality, conversion, early reoperation, surgical complications, GJA leakage or stricture, and bariatric results. The only significant differences between the two groups were in regards to operating time (190 min for stapled GJA vs. 160 min for hand-sewn GJA, p value 0.029) and operating supply cost (100 Euros less for hand-sewn GJA). In our experience, hand-sewn GJA during LRYGB appears to be as safe as linear-stapled GJA and provides the same bariatric results while remaining slightly less expensive.
authors.affiliation: Department of Endoscopic Surgery, Haut Lévèque Hospital, Bordeaux, France. julienjarry@hotmail.com
authors.forename: Julien
authors.initials: J
authors.lastname: Jarry
authors.forename: Tristan
authors.initials: T
authors.lastname: Wagner
authors.forename: Marie
authors.initials: M
authors.lastname: de Pommerol
authors.forename: Antonio
authors.initials: A
authors.lastname: Sa Cunha
authors.forename: Denis
authors.initials: D
authors.lastname: Collet
mesh_terms: D000328:Adult; D000368:Aged; D015992:Body Mass Index; D016009:Chi-Square Distribution; D005260:Female; D015390:Gastric Bypass / Q000379:methods*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009767:Obesity, Morbid / Q000601:surgery*; D012189:Retrospective Studies; D018709:Statistics, Nonparametric; D017792:Surgical Stapling; D013536:Suture Techniques; D013997:Time Factors; D016896:Treatment Outcome; D015431:Weight Loss