Suture Line Buttresses Are Not Associated with Fewer Complications in Roux-en-Y Gastric Bypass

Introduction Suture line complications can cause major morbidities and mortality after Roux-en-Y gastric bypass. Suture line buttresses have been used in an attempt to prevent these complications. This study was done to determine if the introduction of suture line buttressing to our practice has decreased our complication rate.
Methods After obtaining IRB approval, our database was queried for the following complications: leak, endoscopy, dilation, GI bleed, readmission, reoperation and thirty-day mortality. The incidence of these complications before and after the introduction of suture line buttressing was compared using chi-squared.

Results There were 2499 Roux-en-Y gastric bypasses. Two thousand two hundred thirty patients were operated on without buttressing, while buttresses were used in 269 cases. There were 5 deaths among patients without buttresses (0.2%) and 3 among patients with buttresses (1.1%); this difference was significant (p=0.015). The incidence of complications in each group is shown in the table.

Conclusion The use of suture line buttresses is not associated with decreased suture line complications in this study. The power of this study is limited by smaller numbers of patients who received buttresses and the rarity of the events analyzed. The increased mortality is most likely a Type I error given that complications are not increased. Larger studies may identify differences, but such small gains may not be cost-effective.

Session: Poster

Program Number: P069

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