Sertac Usta, MD1, Koray Karabulut1, Hakan Artas, MD2. 1Firat University School of Medicine General Surgery Department, 2Firat University School of Medicine Radiology Department
Introduction: Sleeve gastrectomy represents one of the most common surgical procedure used in bariatric surgery. The most feared complication following laparoscopic sleeve gastrectomy is the leak that occurs at the staple line. One method to reduce the risk of leak is the use of reinforcement material at the suture line. In this study, the efficacy of sutures and fibrin glue in the prevention of staple leak has been compared retrospectively.
Materials and Methods: A total of 250 patients undergoing LSG between October 2011 and August 2015 at the Medical Faculty of Firat University were retrospectively assessed using the hospital database system records.
Results: There were 77 males (31%) and 173 (69%) females, with a mean age of 34 years (range: 16-65 y), and body mass index of 45 kg/m2. While no reinforcement material was used in 61 patients (24%) at the suture line, reinforcement sutures or fibrin glue were used in 54 (22%) and 135 (54%) patients, respectively. Postoperative leak occurred in 8 patients (3.2%), and 6 (9.8%) of these had no use of reinforcment material for leak prevention, while additional sutures or fibrin glue had been used in 2 patients, one in each group (0.7%). One patient died due to leak and the consequent development of sepsis (0.4%).
Discussion: LSG is increasingly more frequently used in bariatric surgery practice. However, an increase also occurs in the rate of complications. A discrepancy exists in the published literature regarding the benefit of reinforcment the suture line on the risk of leak risk. In our patient series, patients without the use of additional material in the staple line had a significantly increased risk of leak.
Conclusion: Despite some controversy, strong evidence exists on the effectiveness of fibrin glue in the prevention of leaks in patients undergoing laparoscopic sleeve gastrectomy.
Presented at the SAGES 2017 Annual Meeting in Houston, TX.
Abstract ID: 86377
Program Number: P614
Presentation Session: iPoster Session (Non CME)
Presentation Type: Poster