A retrospective study of staple line bleeding in laparoscopic sleeve gastrectomy

Abstract

Objective To explore the related factors and preventive treatments of staple line bleeding in laparoscopic sleeve gastrectomy(LSG). Methods From Jan. 2017 to Dec. 2018, 82 cases received LSG, of whom clinical data were analyzed retrospectively. Statistical analysis were performed by using SSPS20.0 software. Staple line bleeding, periphery vessels clamping treatment and intraoperative blood pressure level were examined by using χ2 test. Results BMI≥40, hypertension and obstructive sleep apnea(OSA) were closely correlated with the rate of gastric staple line bleeding.(P<0.01). There were 60 cases (73.2%) of intraoperative bleeding of the gastric staple line and 22 cases (26.8%) of less bleeding. In the 28 cases of ligating peripheral vessels with Ligasure prior to stapling, 10 cases occurred obvious staple line bleeding. While 50 cases occurred obvious staple line bleeding in the 54 cases without preventive clamping (χ2=30.39, P=0.000). There were 26 patients with blood pressure ≥130 mmHg and 56 patients with blood pressure ≤130 mmHg during stapling of the greater curvature. Among the 26 patients with blood pressure ≥130 mmHg and the 56 patients blood pressure ≤130mmHg during stapling, 14 and 15 cases required intervention respectively (χ2=5.69, P=0.017). Conclusion Preventive clamping of periphery vessels and decreasing blood pressure could prevent staple line bleeding effectively in LSG, and clamping periphery vessels with Ligasure and decreasing blood pressure below 130mmHg could reduce the staple line bleeding. Key words: Sleeve gastrectomy; Laparoscopes; Blood vessels; Blood pressure; Blood loss, surgical