Clinical Efficacy of Jejunojejunostomy Leak Test Using Methylene Blue During Laparoscopic Roux-en-Y Gastric Bypass on Post-Operative Leak Rate

Abstract

Background: Obesity is becoming a worldwide health problem. Recently, bariatric surgeries are developing to combat with thisproblem. However, these surgical methods themselves have risks.Objectives: The present study investigated the preventive effect of routine leak test of both gastrojejunal and jejunojejunal anastomosesimmediately after laparoscopic Roux-en-Y gastric bypass (LRYGB) surgery against post-operative leak by inexperienced surgeons.Methods: In a prospective interventional study, this research enrolled 52 morbid obese patients with LRYGB from September 2014to October 2016. After anastomoses, methylene blue and air leak tests were performed and the section line and both anastomosissites for patency and inspected for air and dye leaks were examined.Results: Mean body mass index of patients was 48.84±6.8 kg/m2. Twelve patients had positive leak test and the anastomoses werereinforced by additional sutures. All patients were discharged with no leak and no patient had leak during the routine follow-up period.Conclusions: Intraoperative leak test of both gastrojejunal and jejunojejunal anastomoses is a valuable test in the assessment ofleak during LRYGB surgery, especially in unskilled surgeons.

Keywords

• obesity
• gastric bypass
• leak rate
• gastrojejunal anastomosis
• jejunojejunal anastomosis
• learning curve