Background Staple-line reinforcement has been used with promising
results in laparoscopic gastric bypass in order to reduce leakage,
increase staple-line integrity, and diminish staple-site bleeding. The
purpose of this study was to determine if staple-line reinforcement with
bovine pericardial strips reduces surgical complications of laparoscopic
sleeve gastrectomy (LSG).
Methods This is a prospective comparative study of all patients who
underwent LSG by a standard operative team in an 18-month period.
Patients were enrolled in group A if they received staple-line
reinforcement and in group B when not. The staple line was reinforced
with bovine pericardium strips [Peri-Strips Dry (R) (PSD)].
Results In total, 187 patients, with a median preoperative BMI of 45.3
kg/m(2) (range = 35.1-72.7), underwent LSG. Ninety-six patients were
enrolled in group A and 91 in group B; the two groups were comparable in
their various characteristics. Morbidity rate representing grade III-IV
surgical complications reached 7.4% and mortality rate was 0.5%.
Reinforcement with PSD significantly reduced the occurrence of bleeding
from the staple line and intra-abdominal collections (P = 0.012 and
0.026). The leak rate was not significantly reduced in group A. Patients
in group A required fewer days of hospitalization.
Conclusions Reinforcement of the staple line in LSG resulted in
significantly fewer surgical complications compared to standard stapling
of the gastric tube. The additional cost due to the reinforcement of the
staple line may be counterbalanced by the reduction in the length of
hospitalization