Laparoscopic sleeve gastrectomy : is there a need to reinforce the staple-line ?

Abstract EN

Objectives : To assess the effect of staple-line reinforcement on the rate of staple-line leak and bleeding post laparoscopic sleeve gastrectomy.

Methods : In this retrospective study we analyzed 326 patients who underwent laparoscopic sleeve gastrectomy at King Hussein Medical Center between January 2010 and April 2016.

Staple-line reinforcement using continuous lembert suture method was used in 229 patients (reinforcement group) while it was not used in 97 patients (non-reinforcement group).

Patient characteristics, comorbidities, duration of surgery, hospital stay, as well as complications including staple-line leak and bleeding after surgery were obtained, analyzed and compared between the reinforcement and non-reinforcement groups.

Results : Patients of the reinforcement group had baseline characteristics and comorbidities similar to those in the non-reinforcement group but had two cases of leak (0.87%) and two cases of bleeding (0.87%).While patients of the non-reinforcement group had one case of leak (1.03%) and five cases of bleeding (5.15%).

Although there was no significant difference regarding leak rate between the two groups (P =1.000), bleeding rate was significantly decreased in the reinforcement group (P=0.026).

One of the patients with leak died in the reinforcement group while there were no deaths in the non- reinforcement group.

Conclusion : According to our results; reinforcement of the staple-line by lembert suture in laparoscopic sleeve gastrectomy reduced the incidence of staple-line bleeding but was associated with prolongation in operation time compared with no staple-line reinforcement.

While the difference in leak rate between the two groups was not significant