Gideon Sroka, MD, Daria Milevski, MD, Husam Mady, MD, Ibrahim Matter, MD. Bnai-Zion Medical Center
Introduction: blood pressure control during stomach resection and suture reinforcement of the stapler line have been shown in a randomized trial to minimize hemorrhagic complications in laparoscopic sleeve gastrectomy (LSG). The purpose of this study is to evaluate patient outcome after implementing this anti-bleeding policy for patients outside of a clinical trial.
Methods: all patients who went through LSG in our department between 4/2014 to 12/2016 have been evaluated for bleeding complications, after implementation of anti-bleeding policy: blood pressure was controlled to 140 mmHg during stomach resection and staple line was reinforced throughout it's length with a running 3-0 absorbable v-lock suture. Drains were used selectively.
Results: out of 308 patients who went through the procedure 9 (2.9%) suffered hemorrhagic complications: 7 patients had ?Hb>2gr%. 7 patients received 1-3 red blood PC's. No patients were re-operated for bleeding. 2 patients were re-admitted for infected hematoma and had CT guided drainage. One patient (0.3%) suffered from leak.
Conclusion: implementation of anti-bleeding policy in LSG is very effective. There is no need to use expensive buttress material to achieve these results. Drains can be used selectively. The impact of this policy on leak rate needs to be evaluated in a larger cohort.
Presented at the SAGES 2017 Annual Meeting in Houston, TX.
Abstract ID: 87967
Program Number: P730
Presentation Session: iPoster Session (Non CME)
Presentation Type: Poster
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