Document Detail


Fully stapled gastric bypass with isolated pouch and terminal anastomosis: 1-3 year results.
MedLine Citation:
PMID:  12194549     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Roux-en-Y gastric bypass is a bariatric procedure of choice. There is evidence supporting a small isolated pouch and a wide anastomosis. Gastric vascular anatomy renders the ventral aspect less suited for anastomotic construction. The lesser curvature has abundant blood supply that should preferably not be interfered with. Terminal anastomosis is a logical choice. METHODS: We devised a way of making a fully stapled gastric bypass with complete separation of a pouch that empties dependently. The technique obviates the oral passage of the stapler anvil. Such a procedure facilitates the creation of an "end-of-pouch to end-of-jejunal limb" wide-diameter anastomosis and precludes the risk of staple-line disruption. RESULTS: Since October 1997 we have performed 227 such anastomoses (146 primary, 81 reoperative procedures) in consecutive patients with no leaks, no gastro-gastric fistulas and no mortality. The postoperative hospital time was 3.6 (3-8) days (median, range). In primary operations baseline BMI was 47.5, 1-yr 29.7 and 3-yr 29.2. Corresponding values for reoperations were 39.3, 30.8 and 31.5. Weight loss was adequate, and complications were limited to three anastomotic ulcers and two narrow stomas without visible ulcers but necessitating endoscopic dilatation. CONCLUSION: The technique confers distinctive advantages.
Authors:
J L Hedenbro; S G Frederiksen
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Obesity surgery     Volume:  12     ISSN:  0960-8923     ISO Abbreviation:  Obes Surg     Publication Date:  2002 Aug 
Date Detail:
Created Date:  2002-08-26     Completed Date:  2003-01-14     Revised Date:  2007-12-05    
Medline Journal Info:
Nlm Unique ID:  9106714     Medline TA:  Obes Surg     Country:  Canada    
Other Details:
Languages:  eng     Pagination:  546-50     Citation Subset:  IM    
Affiliation:
Department of Surgery, Lund University, Sweden. jan.hedenbro@kir.lu.se
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MeSH Terms
Descriptor/Qualifier:
Adult
Anastomosis, Roux-en-Y / methods*
Blood Loss, Surgical
Blood Volume
Body Mass Index
Female
Gastric Bypass / methods
Humans
Male
Middle Aged
Obesity, Morbid / surgery*
Postoperative Complications
Prospective Studies
Reoperation
Surgical Stapling / methods*
Treatment Outcome
Weight Loss

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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