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Gastric Bypass: EEA vs GIA Stapled Gastrojejunal Anastomosis

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Results of Laparoscopic Gastric Bypass: EEA vs GIA Stapled Gastrojejunal Anastomosis

Various surgical techniques have been successfully applied to isolated Roux-en-Y gastric bypass (RYGBP). Many surgeons rely on stapling devices for the gastrojejunal (GJ) anastomosis. Early follow-up results were compared for two laparoscopic techniques for GJ anastomosis: circular end-to-end (EEA) and linear cutting (GIA) staplers.

Method

Medical charts were retrospectively reviewed of all patients who had undergone stapled gastrojejunal anastomosis for isolated RYGBP over a 2-year period. The jejunal limb used for GJ anastomosis was fashioned at 1 cm / unit body mass index (BMI). Patients were grouped by gastrojejunal anastomotic technique, EEA or GIA, and the results compared.

Results

61 patients underwent Roux-en-Y gastric bypass, with no differences in preoperative BMI or co-morbidities. Mean (+/-SD) operative time was shorter for the GIA group. There were 2 early re-operations in the GIA group for anastomotic leaks. Postoperative complications were not statistically different; however, there was an increased incidence of wound infections in the EEA group vs the GIA group (21.9% vs 6.9%). Follow-up at 6-8 months revealed an average percent excess weight loss of 46.7%+/-12.2% for EEA and 51.4%+/-10.7% for GIA. Length of stay, total hospital costs and operating-room costs were similar.

Conclusion

Operative time was significantly shorter in the GIA group. Complications, length of stay, weight loss and costs were similar between the groups. Selection of anastomotic technique may be based on surgeon preference, operative time, and potential for serious complications.

Source:
Shope TR, Cooney RN, McLeod J, Miller CA, Haluck RS. Department of Surgery, Penn State Milton S. Hershey Medical Center, Hershey, PA 17033, USA.
National Library of Medicine 2003

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Laparoscopic or open bariatric surgery, such as gastric banding or bypass is not an easy solution to morbid obesity and weight loss. It is a serious surgical procedure, involving health risks. To produce lasting weight loss it requires a long-term patient commitment to eating a healthy diet and following a regular program of physical exercise. Life-long use of nutritional supplements may also be necessary. So, before deciding, discuss your options fully with your doctor. © 2003-2008 Bariatric-Surgery.Info - Terms - Contact - Information - Resources - Add URL