DUODENAL STUMP SEALING BY STAPLERS - PRACTICE REPORT - METAL CLIPS VERSUS ABSORBABLE STAPLES

The main observation criterion of the present retrospective study is t he insufficiency rate after machine closing of the duodenal stump (TA- clip seam device, Auto-Suture), as a consequence of gastrectomy, resec tion of the stomach with Billroth II respective Roux-Y reconstruction, depending on the used type of clip. Between January 1, 1985 and Octob er 2, 1989 the closing of the duodenal stump was routinely carried out with metal clips (n = 253) in the City Hospital Offenbach. Between Oc tober 3, 1989 and December 31, 1991 polysorb staples (n = 96) were exc lusively used. The patient collectives were comparable regarding age, sex, health status, basic diseases, accompanying diseases and surgical methods. Closing of the duodenal stump by polysorb staples demonstrat ed with 13.5 % more dehiscent seams than with metal clips (4.7 %). As a result of the present study, we cannot recommend the use of polysorb clips for the closing of the duodenal stump.