STAPLE-LINE DISRUPTION FOLLOWING VERTICAL BANDED GASTROPLASTY

Background: The purpose of this study was to determine the frequency w ith which staple-line disruption occurs following vertical banded gast roplasty (VBG) in morbidly obese patients, to investigate the effect o f this complication on weight loss, and to identify any clinical sympt oms that might be associated with staple-line disruption. Methods: Fro m April of 1992 to June of 1994, 60 patients with morbid obesity under went VBG. Double-contrast radiographic examination of the upper gastro intestinal tract was performed on all patients at 6, 12, 24, and 36 mo nths postoperation to assess the integrity of the staple line. At thes e same times, the weight of each patient was measured, so that the pat ients found to have staple-line disruption could be compared to those without disruption in terms of weight loss. Results: Over the duration of the study, staple-line disruption was found in 12 patients (20%). All of these patients demonstrated satisfactory weight loss. Between t he group of patients with staple-line disruption versus the group with out disruption, weight loss did not differ significantly at any time u p to 3 years postoperation. In addition, in the patients with staple-l ine disruption, no clear symptomatology that might be associated with this complication was discovered. Conclusions: Our results lead to the conclusion that small disruptions in the staple line lack clinical im portance and do not significantly affect weight loss for at least the first 3 postoperative years. Furthermore, staple-line disruption does not seem to be associated with any specific clinical symptoms. Follow- up of all patients via barium meal is the correct approach for discove ring the exact incidence of this complication. (C) 1998 Rapid Science Ltd.