Fewer Gastrojejunostomy Strictures and Marginal Ulcers with Absorbable Suture

BACKGROUND: The upsurge of gastric bypass procedures has been accompanied by an increase in anastomotic strictures and marginal ulcers. In the reported literature, the gastrojejunostomy strictures in 3-27% and ulcerates in 1-16% of cases. Several anastomotic techniques are used; however, no study has specifically addressed whether choice of reinforcing suture affects rates of stricture or ulcer. We reviewed our case series to determine if a protocol change in suture choice altered the incidence of anastomotic strictures and marginal ulcers.
METHODS: We performed a retrospective review of a prospectively collected database for 291 primary Roux-en-Y gastric bypass patients (8/1/99 to 9/1/07). Nearly all patients had a 25-mm circular stapled anastomosis with an outer suture layer for reinforcement. Before 5/30/06, 231 patients had interrupted permanent suture, and after 5/30/06, 60 patients had interrupted absorbable suture. We compared overall rates of stricture, marginal ulceration and aggregate gastrojejunostomy complications between the two groups using a proportional hazards model and log-rank statistic. A p value

Session: Podium Presentation

Program Number: S086