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ABSTRACT: Background: We evaluated the safety and feasibility of performing a laparoscopic intracorporeal end-toside small bowel anastomosis
using a stapling technique as part of a Roux-en-Y gastric bypass operation (RYGBP). Methods: 80 consecutive patients who underwent
RYGBP with laparoscopic jejunojejunostomy were evaluated. Operative time and intraoperative and postoperative complications
directly related to the jejunojejunostomy anastomosis were recorded. Results: All 80 laparoscopic jejunojejunostomy procedures
were successfully performed without conversion to laparotomy. Mean operative time was longer for the first 40 laparoscopic
RYGBP than for the last 40 RYGBP (32±18 min vs 21±14 min, respectively, p<0.05). Intraoperative complications were staple-line
bleeding (2 patients) and narrowing of the anastomosis (1 patient). Postoperative complications were four small bowel obstructions:
technical narrowing at jejunojejunostomy site (2 patients), angulation of the afferent limb (1 patient), and food impaction
at the jejunojejunostomy anastomosis (1 patient). These four patients underwent successful laparoscopic re-exploration and
creation of another jejunojejunostomy proximal to the original anastomosis. There were no small bowel anastomotic leaks. The
median time to resuming oral diet was 2 days. Conclusions: Laparoscopic jejunojejunostomy as part of the RYGBP operation is
a safe and technically feasible procedure. Postoperative small bowel obstruction is a potential complication, which can be
prevented by avoiding technical narrowing of the afferent limb.
Obesity Surgery 03/2001; 11(2):196-199. · 3.29 Impact Factor
