Updates Surg. 2026 May 21. doi: 10.1007/s13304-026-02675-x. Online ahead of print.
ABSTRACT
Laparoscopic sleeve gastrectomy (LSG) is currently the most commonly performed weight loss surgery. Omentopexy is believed to help reduce the risk of postoperative nausea and vomiting (PONV), bleeding, gastric leakage, and gastroesophageal reflux disease (GERD). In recent years, fibrin glue posterior fixation has emerged as an alternative method shown to reduce gastrointestinal symptoms after LSG surgery. However, the comparative evidence between these two fixed techniques is still limited. This study aims to compare the clinical efficacy of two gastric fixation methods, fibrin glue posterior fixation and Omentopexy, in LSG. This retrospective study included 649 patients who underwent LSG between 2022 and 2024, divided into two groups: fibrin glue posterior fixation (n = 331) and Omentopexy (n = 318). A 1:1 propensity score-matching (PSM) was performed to balance baseline characteristics between the groups. After matching, 480 patients were included (240 per group). There were no significant differences between the fibrin glue posterior fixation group and the Omentopexy group in operative time or intraoperative blood loss (P > 0.05). The incidence of PONV in the two groups was 6.6% (16/240) and 5.8% (14/240), respectively, with no statistically significant difference (P > 0.05). The incidence of postoperative bleeding was 0.8% (2/240), and there was no significant difference between the groups (P > 0.05). There was 1 case of gastric leakage (0.4%) in the fibrin glue posterior fixation group, and no gastric leakage was observed in the Omentopexy group, and the difference between the groups was not statistically significant (P > 0.05). Neither group experienced gastric torsion. The incidence of postoperative GERD was 5.8% (14/240) and 7.5% (18/240), respectively, with no statistically significant difference (P > 0.05). In addition, both groups of postoperative bleeding patients underwent reoperation, with a reoperation rate of 0.8% (2/240), and there was no significant difference between the groups (P > 0.05). This study demonstrates that there were no significant differences in short-term postoperative complications between fibrin glue posterior fixation and Omentopexy in LSG.
PMID:42166091 | DOI:10.1007/s13304-026-02675-x
