Weight loss one year after laparoscopic roux-en-Y gastric bypass is not dependent on the type of gastrojejunal anastomosis.

Abstract

Laparoscopic roux-en-Y gastric bypass (LRYGB) is the gold standard weight-loss procedure. There are different techniques to perform the gastrojejunal (GJ) anastomosis, but there is no consensus as to which one is superior for weight loss. Our goal in this study was to assess one-year weight loss after LRYGB comparing the three different techniques at our tertiary care center. The American college of surgeons (ACS) Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program (MBSAQIP®) data for Montefiore Medical Center for years 2014-2017 were analyzed. Three surgeons were included in this study; each type of anastomosis was performed by a single surgeon. Patients were included if they underwent primary LRYGB. Patients were designated to one of three different groups depending of the type of gastrojejunal anastomosis performed: hand sewn, circular stapled, or linear stapled. One-year weight loss wasassessed as primary endpoint of the study. A descriptive analysis of perioperative variables for each group was included as well. A total of 1011 patients underwent primary LRYGB. 429 (42.1%) were performed with circular-stapled GJ anastomosis, 433 (42.5%) with a hand-sewn GJ anastomosis, and 149 (14.6%) linear-stapled GJ anastomosis. The median BMI was 46.08 ± 6.43, with no difference between groups (p = .405). Procedure time was 106.70 ± 28.23min for the circular group, 108.27 ± 28.59min for the hand-sewn group, and 115.78 ± 36.11min for the linear group (p > 0.005). There were no significant differences in complications except for the need of postoperative transfusions (p < 0.002). There was no statistically significant difference in %EWL one year after surgery: %EWL was 58.81 ± 16.54kg for hand sewn, 58.86 ± 14.84kg for circular, and 59.20 ± 17.58Kg for linear. (p = .595). There is no difference in weight loss one year after LRYGB based on the type of gastrojejunal anastomosis performed.