Naeem Muhammad Saulat, Ul Ain Rooh, Sadiq Zoya, Ejaz Aniqa, Rafi Usama, Awais Muhammad, Ul Hassan Maaz
Surgery, Mayo Hospital, Lahore, PAK.
Surgery, Shalamar Medical and Dental College, Lahore, PAK.
Cureus. 2023 Apr 7;15(4):e37271. doi: 10.7759/cureus.37271. eCollection 2023 Apr.
In Pakistan and worldwide, there is a lack of literature on the role of ligation clips in controlling hemostasis in laparoscopic sleeve gastrectomy. ligation clips are being used to secure hemostasis and act as staple line reinforcement to prevent intra-operative and postoperative bleeding. Data can be utilized to reflect the role of staple line reinforcement with ligation clips so as to guide surgeons about its safety and efficacy.
This retrospective observational study was conducted at the Shalamar Hospital, Lahore, Pakistan, and included 120 patients. The patients' demographic parameters, BMI, intra-operative and postoperative bleeding in terms of hematemesis, melena, and fall in hemoglobin (Hb) postoperatively were compared to preoperative Hb and recorded.
One hundred and twenty cases of laparoscopic sleeve gastrectomy (LSG) were included with a mean age of 44.77±12.05 years. The mean BMI was 52.06±13.85 preoperatively. The mean drop in hemoglobin was 0.04±0.26 with a p-value of 0.07, which is statistically insignificant. Among 120 cases, two (1.7%) patients reported episodes of melena, and four (3.3%) patients reported hematemesis. Postoperative hypotension was recorded in six (5%) patients and eight (6.7%) patients had postoperative tachycardia.
This study shows ligation clip application along the staple line is an effective means of hemostasis similar to suture application.
在巴基斯坦乃至全球，关于结扎夹在腹腔镜袖状胃切除术中控制止血作用的文献都很匮乏。结扎夹被用于确保止血，并作为吻合钉线加固物以预防术中及术后出血。相关数据可用于反映结扎夹对吻合钉线的加固作用，从而指导外科医生了解其安全性和有效性。
这项回顾性观察研究在巴基斯坦拉合尔的沙勒马医院开展，纳入了120例患者。比较了患者的人口统计学参数、体重指数（BMI）、术中及术后因呕血、黑便以及术后血红蛋白（Hb）下降所导致的出血情况，并与术前Hb进行比较并记录。
纳入了120例腹腔镜袖状胃切除术（LSG）病例，平均年龄为44.77±12.05岁。术前平均BMI为52.06±13.85。血红蛋白平均下降0.04±0.26，p值为0.07，无统计学意义。在120例病例中，2例（1.7%）患者出现黑便，4例（3.3%）患者出现呕血。6例（5%）患者记录到术后低血压，8例（6.7%）患者出现术后心动过速。
本研究表明，沿吻合钉线应用结扎夹是一种与应用缝线类似的有效止血方法。
