CONTINOUS SINGLE LAYER ANASTOMOSIS IN THE GASTROINTESTINAL AND BILIARY TRACTS

Abstract

From July 1995 to October 1997 all patients with gastric, enteric, colonic and bilioenteric anastomoses were included in a prospective study. Sixty- seven anastomoses were performed on 46 patients during this period. The age of the patients ranged from 15 to 78 years, with a mean age of 54 years. All of the procedures were elective and mechanical bowel preparation performed on patients operated by colorectal surgery. Intestinal, colonic and gastric anastomoses were performed using an open single layer serosubmucozal technique. Biliary-enteric anastomoses were made with a single layer of continous sutures taking the full thickness of the bile duct or gallbladder and the serosubmucozal layers of the intestine. Information relating to diagnoses, operations and outcome was recorded on standart forms at the time of operation, on discharge and at follow-up 1 month, 6 months and 1 year after leaving hospital. Follow-up ranged from a minimum of 1month to 30 months. Complications that included anastomotic leak, stricture, obstruction of the bowel, wound complications, prolonged ileus, unexplained fever, suture line bleeding and death were analysed. The diagnosis of anastomotic leakage was made on clinical criteria. One patient that operated for pancreatic cancer developed signs of an anastomotic leak. Anastomotic stricture and intraabdominal collection developed in one patient. There were four deaths and two wound complications.