Suture: Complications After Gastric Bypass Surgery
OUTCOMES OF ABSORBABLE VERSUS NON-ABSORBABLE SUTURE AT THE GASTRO-JEJUNOSTOMY AFTER LAPAROSCOPIC GASTRIC BYPASS
J K Champion MD, Mike Williams MD. Northside Hospital, Atlanta GA.
Presented at ASBS 2007
Introduction: Controversy exists whether the suture material (absorbable versus non-absorbable) contributes to the incidence of stoma stenosis or marginal ulcer at the gastro-jejunostomy after gastric bypass. This retrospective study reviews our results with three different suture materials.
Methods: 178 patients underwent a laparoscopic ante-colic gastric bypass using silk (42), neurolon (49), or vicryl (87) suture to close the anterior enterotomy after a linear endostapler technique to perform the end to side gastro-jejunostomy over a 30 Fr bougie. There were 30 males and 148 females, mean age of 41.2 ± 11.1 years, and mean BMI 47.8 ± 8.6 Kg/m². Statistical significance was determined by ANOVA, Chi Square, or Linear to Linear Association with p ≤ .05.
Results: Groups were similar for gender, age, BMI and race. Follow-up was 17-30 months (mean = 23) in 100% of patients. The incidence of positive intra-operative air leak test was significantly greater for vicryl (p= .09). Neurolon (2%) demonstrated significantly less stoma stenosis (p= .03) than silk (7%) or vicryl (13%). The incidence of marginal ulcer was similar between groups. (neurolon 0%, silk 2.4%, vicryl 2.3%)
Conclusion: Neurolon suture demonstrated a significant reduction in stoma stenosis compared to silk or vicryl suture, with no increase in marginal ulceration in this study.