Basu N N, Leschinskey D, Heath D I
Department of Surgery, Queen Elizabeth Hospital, Woolwich, London, SE18 4QH, UK.
Obes Surg. 2008 Jul;18(7):896-7. doi: 10.1007/s11695-008-9512-0. Epub 2008 May 6.
Anastomotic and staple line leak following laparoscopic gastric bypass are recognised complications with significant mortality and morbidity. Several techniques have been described to reduce the incidence of staple line leaks, including reinforcement of staple lines using omental wraps, fibrin glue, and Peristrips and Seamguard. Using a similar principle, we describe a case report of the successful use of a Seamguard buttress in the repair of a staple line leak at the proximal gastric pouch following laparoscopic gastric bypass. The repair of the leak was confirmed by gastrogaffin contrast study as well as clinically as the patient progressed well in the postoperative period. Ten months following surgery, her weight had reduced from 125 kg (BMI 47.6 kg/m(2)) to 82.4 kg (BMI of 31.4 kg/m(2)). We suggest that surgeons facing similar problems may choose to employ this novel technique.
腹腔镜胃旁路术后吻合口及吻合钉线漏是公认的并发症，具有较高的死亡率和发病率。已经描述了几种降低吻合钉线漏发生率的技术，包括使用网膜包裹、纤维蛋白胶、Peristrips和Seamguard加强吻合钉线。基于类似原理，我们报告一例成功使用Seamguard支撑物修复腹腔镜胃旁路术后近端胃囊吻合钉线漏的病例。通过胃造影剂造影研究以及临床观察证实了漏口的修复，因为患者术后恢复良好。术后十个月，她的体重从125千克（BMI 47.6千克/平方米）降至82.4千克（BMI 31.4千克/平方米）。我们建议面临类似问题的外科医生可选择采用这种新技术。
