Ivy N Haskins, MD, Ada Graham, MD, Sheena W Chen, MD, Andrew D Sparks, MS, Paul P Lin, MD, FACS, Hope T Jackson, MD, Khashayar Vaziri, MD, FACS. George Washington University
Introduction: Laparoscopic sleeve gastrectomy (SG) is the most commonly performed bariatric procedure in the United States. Despite its prevalence, there are many technical factors related to this procedure that are not standardized. Specifically, the size of the bougie used and the distance from the pylorus used to create the gastric sleeve varies both by surgeon and across institutions. The purpose of this study was to determine if there was an association between either bougie size or distance from the pylorus on the rate of dehydration following laparoscopic SG.
Methods: All patients undergoing first-time, elective laparoscopic SGs from 2015-2016 were identified within the American College of Surgeons Metabolic and Bariatric Surgery Quality Program (ACS-MBSAQIP) database. The association of bougie size and distance from the pylorus on the rate of dehydration following laparoscopic SG within the first 30-days postoperatively was investigated using multivariate logistic regression analysis.
Results: A total of 170,751 patients met inclusion criteria. The most commonly used bougie size was 36 French (Fr) and the most common distance from the pylorus was 5 centimeters (cm). The patients were divided into four different groups based on bougie size and distance from the pylorus. Group 1 included bougie size <36Fr and pylorus distance <4cm, Group 2 included bougie size >36Fr and pylorus distance <4cm, Group 3 included bougie size >36Fr and pylorus distance >4cm, and Group 4 included bougie size <36Fr and pylorus distance >4cm. Patients in Group 4 were significantly less likely than patients in Group 1 to be treated for dehydration within the first 30 days postoperatively (p=0.04). There were no other statistically significant differences between the four groups.
Conclusion: Distance from the pylorus, but not bougie size, is significantly associated with dehydration requiring treatment following laparoscopic SG. Specifically, a longer distance from the pylorus is significantly associated with a decreased risk of being treated for dehydration within the first 30-days following laparoscopic SG (OR: 0.82, CI: 0.67-0.99, p=0.04). Consideration should be made for standardizing distance from the pylorus during laparoscopic SG.
Presented at the SAGES 2017 Annual Meeting in Houston, TX.
Abstract ID: 94566
Program Number: P048
Presentation Session: Poster Session (Non CME)
Presentation Type: Poster