Melanie Lauti1, Sophie E Gormack2, Jeni M Thomas3, Jon J Morrow3, Habib Rahman3, Andrew D MacCormick2,3. 1. Department of Surgery, University of Auckland, Auckland, New Zealand. m.lauti@auckland.ac.nz. 2. Department of Surgery, University of Auckland, Auckland, New Zealand. 3. Department of General Surgery, Middlemore Hospital, Counties Manukau Health, Auckland, New Zealand.
Abstract
INTRODUCTION: Staple-line leak and haemorrhage are the most serious complications following sleeve gastrectomy. The operation is often performed without prior endoscopy. Given that gastric inflammatory conditions are common, could they predispose patients to suffering a serious complication following sleeve gastrectomy? METHODS: Consecutive patients undergoing laparoscopic sleeve gastrectomy from March 2007 to May 2014 were included in the study. All final histologic reports were coded and investigated against whether or not the patient had a post-operative leak and/or haemorrhage. Associations were explored using Fisher's exact test. RESULTS: Over this period, 976 laparoscopic sleeve gastrectomies were performed with a pre-operative gastroscopy rate of 2.2%. Over half of the specimens demonstrated a histopathologic abnormality. Helicobacter pylori infection occurred in 8.6%, and the most common histopathologic abnormality was chronic gastritis in 38.9%. There was no association between H. pylori infection or inflammation and staple-line leak and/or haemorrhage. CONCLUSION: We conclude that inflammatory gastric conditions are unlikely to predispose patients to staple-line leaks or haemorrhages following sleeve gastrectomy and that selective pre-operative gastroscopy may be an appropriate standard of care.
INTRODUCTION: Staple-line leak and haemorrhage are the most serious complications following sleeve gastrectomy. The operation is often performed without prior endoscopy. Given that gastric inflammatory conditions are common, could they predispose patients to suffering a serious complication following sleeve gastrectomy? METHODS: Consecutive patients undergoing laparoscopic sleeve gastrectomy from March 2007 to May 2014 were included in the study. All final histologic reports were coded and investigated against whether or not the patient had a post-operative leak and/or haemorrhage. Associations were explored using Fisher's exact test. RESULTS: Over this period, 976 laparoscopic sleeve gastrectomies were performed with a pre-operative gastroscopy rate of 2.2%. Over half of the specimens demonstrated a histopathologic abnormality. Helicobacter pyloriinfection occurred in 8.6%, and the most common histopathologic abnormality was chronic gastritis in 38.9%. There was no association between H. pyloriinfection or inflammation and staple-line leak and/or haemorrhage. CONCLUSION: We conclude that inflammatory gastric conditions are unlikely to predispose patients to staple-line leaks or haemorrhages following sleeve gastrectomy and that selective pre-operative gastroscopy may be an appropriate standard of care.
Authors: D P Lemanu; P P Singh; K Berridge; M Burr; C Birch; R Babor; A D MacCormick; B Arroll; A G Hill Journal: Br J Surg Date: 2013-01-21 Impact factor: 6.939
Authors: Li Ge; Rena C Moon; Ha Nguyen; Luiz Gustavo de Quadros; Andre F Teixeira; Muhammad A Jawad Journal: Surg Endosc Date: 2019-02-15 Impact factor: 4.584