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Closed or Unclosed Mesentery? A Meta-analysis of Internal Herniation After Laparoscopic Roux-en-Y Gastric Bypass

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Abstract

During the laparoscopic Roux-en-Y gastric bypass procedure, closing mesentery or not was still controversial according to preexisted studies. So, the current meta-analysis aimed to compare the outcome of closure versus non-closure of mesenteric defects in laparoscopic Roux-en-Y gastric bypass. Fifteen studies were included, enrolling 53,488 patients. Based on the outcome of analysis, regarding internal hernia, Petersen space’s IH, jejunal mesenteric’s IH, hospital days, and reoperation, closure of the mesentery was better than non-closure. Besides, small bowel obstruction, anastomosis ulcer, stenosis, leakage, bleeding, gastrointestinal perforation, and postoperative BMI of patients show no difference between non-closure and closure.

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Data Availability

The datasets used and analyzed during the current study are available from the corresponding author upon reasonable request.

Abbreviations

IH :

Internal herniation

LRYGB :

Laparoscopic Roux-en-Y gastric bypass

OR :

Odds ratio

CI :

Confidence interval

BMI :

Body mass index

PRISMA :

Preferred Reporting Items for Systematic Reviews and Meta-Analyses

AMSTAR :

Assessing the methodological quality of systematic reviews

SD :

Standard deviation

MD :

Mean difference

NRCTs :

Non-randomized controlled trials

LSG :

Laparoscopic sleeve gastrectomy

LGB :

Laparoscopic gastric bypass

FPG :

Fasting plasma glucose

HbA1C :

Glycosylated hemoglobin, type A1C

BPD-DS :

Biliopancreatic diversion duodenal switch

T2DM :

Type 2 diabetes mellitus

RCTs :

Randomized controlled trials

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Authors and Affiliations

  1. Guangzhou Medical University, Guangzhou, 510180, China

    Qian-Long Wu, Quan-Zhen Liu, Ying-Yun Xi, Xiao-Qing Deng, Tong-Shan Xu, Zi-Chun Xie, Jin-An Chen & Yi Yuan

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Contributions

Conception and design: Qian-Long Wu. Analysis and interpretation: Qian-Long Wu, Quan-Zhen Liu, Ying-Yun Xi, Zi-Chun Xie. Quality assessment: Qian-Long Wu, Xiao-Qing Deng, Tong-Shan Xu, Jin-An Chen. Statistical analysis: Qian-Long Wu, Quan-Zhen Liu, Ying-Yun Xi, Yi Yuan. Writing the article: Qian-Long Wu, Quan-Zhen Liu, Ying-Yun Xi, Xiao-Qing Deng, Tong-Shan Xu, Zi-Chun Xie, Jin-An Chen, Yi Yuan. Critical revision of the article: Qian-Long Wu, Zi-Chun Xie, Jin-An Chen, Yi Yuan. Final approval of the article: Qian-Long Wu, Quan-Zhen Liu, Ying-Yun Xi, Xiao-Qing Deng, Tong-Shan Xu, Zi-Chun Xie, Jin-An Chen, Yi Yuan. Overall responsibility: Qian-Long Wu.

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Correspondence to Qian-Long Wu.

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Informed consent was obtained from all individual participants included in the study.

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PROSPERO CRD42022348883.

Key Points

1. The current meta-analysis aimed to compare the outcome of closure versus non-closure of mesenteric defects in laparoscopic Roux-en-Y gastric bypass.

2. Based on the outcome of analysis, regarding internal hernia, Petersen space’s IH, Jejunal mesenteric’s IH, hospital days, and reoperation, closure of the mesentery was better than non-closure.

3. Besides, small bowel obstruction, anastomosis ulcer, stenosis, leakage, bleeding, gastrointestinal perforation, and postoperative BMI of patients show no difference between non-closure and closure.

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Wu, QL., Liu, QZ., Xi, YY. et al. Closed or Unclosed Mesentery? A Meta-analysis of Internal Herniation After Laparoscopic Roux-en-Y Gastric Bypass. OBES SURG 33, 1900–1909 (2023). https://doi.org/10.1007/s11695-023-06594-3

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