Background

As morbid obesity increases in prevalence, the most successful treatment for weight loss and comorbid condition resolution is metabolic surgery, including the roux-eny gastric bypass (RNYGB). There is no consensus between handsewn or stapled gastrojejunostomy (GJ) preferred. We compared the patient outcomes between handsewn versus stapled GJ to evaluate stricture development.

Methods

This is a single-institution retrospective analysis of 563 patients who underwent RNYGB between 2020 to 2022. All patients were followed for a minimum of three months. A total of 423 patients underwent stapled GJ and 133 underwent handsewn GJ. Our primary outcome was stricture formation requiring balloon dilation.

Results

There were 423 patients in the stapled groupand 133 in the handsewn group. (Demographic findings table 1). Both groups were comprised of primary and revisional surgeries. the post operative findings included nausea, emesis, gastritis, dehydration, abscess, and GERD. The significant outcomes included; 2 leaks (0.4%), 33 strictures (7.8%), 16 foreign body removal (3.7%), and 9 marginal ulcers (2.1%) in the stapled group versus no leaks, 5 strictures (3%), and one marginal ulcer (0.75%) in the handsewn group. The statistically significant differences were rates of foreign body removal and dehydration. Table 2)

Conclusions

In this single institution study, although not achieving statistical significance, clinically significant stricture rates were more common in the stapled GJ anastomosis.