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Low Incidence of Postoperative Leaks When Using Small-Diameter Calibrated Bougies During Laparoscopic Sleeve Gastrectomy: A Retrospective Cohort Study |
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| Authors: | Sakran Nasser Raziel Asnat Gralnek Ian M. Perry Zvi Mahawar Kamal K. Shikora Scott A. Goitein David |
| Affiliation: | 1.Israeli Center for Bariatric Surgery (ICBS), Assia Medical Group, Assuta Medical Center, Tel Aviv, Israel ;2.Department of Surgery A, Emek Medical Center, Afula, Israel ;3.Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel ;4.Ellen and Pinchas Mamber Institute of Gastroenterology, Emek Medical Center, Afula, Israel ;5.Department of Surgery A, Soroka University Medical Center, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel ;6.Bariatric Unit, Sunderland Royal Hospital, Sunderland, UK ;7.Division of Metabolic and Bariatric Surgery, Department of Surgery, Brigham and Women’s Hospital, Boston, Massachusetts, USA ;8.Department of Surgery C, Chaim Sheba Medical Center, 2 Sheba Rd, Ramat Gan, Israel ;9.Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel ; |
| Abstract: | Background Laparoscopic sleeve gastrectomy (LSG) is a well-established bariatric procedure. A staple line leak is a recognized complication of LSG. Bougie size has been suggested to impact leak rates. In this study, we evaluate the impact of using 32–34F bougie sizes with LSG on early postoperative outcomes including staple line leaks within our practice. MethodsThis is a retrospective cohort analysis of a prospectively maintained database of all LSG procedures performed between January 2012 and December 2018 at a single medical center. Data collected and analyzed included bougie size, postoperative leak rate, need for re-operation, 12-month excess weight loss, and 30-day morbidity and mortality. ResultsDuring the study period, 3153 patients underwent LSG, of whom 1977 (62.7%) were female. Mean age and body mass index (BMI) were 42.9 ± 12.2 years (range 15–76 years) and 42.4 ± 5.2 kg/m2 (range 27–73), respectively. No intraoperative complications or mortality occurred. There was one case of perioperative mortality due to bleeding (0.03%). Early postoperative adverse events occurred in 131 patients (4.1%): 17 leaks (0.5%), 75 bleeds (2.4%), and 39 (1.2%) other. ConclusionThe use of smaller-sized (32–34F) bougies had no impact on staple line leaks in the hands of experienced bariatric surgeons at a high-volume center. |
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