Obesity Surgery

, Volume 29, Issue 6, pp 1946–1953 | Cite as

Systematic Review and Meta-analysis of Circular- and Linear-Stapled Gastro-jejunostomy in Laparoscopic Roux-en-Y Gastric Bypass

  • David EdholmEmail author
Review Article


To compare circular stapler (CS) with linear stapler (LS) in a meta-analysis concerning operative time, anastomotic leaks, wound infections, strictures, and length of stay. Pubmed, Medline, and Scopus were searched for articles published since 2006. Four hundred and five articles were assessed, and 13 articles of which only one was a randomized controlled trial were included in all 49,331 patients from different regions of the world. The pooled analysis shows that operative time was shorter in LS than in CS (weighted mean difference 36.2 min; 95% CI 34.7–37.6.; p < 0.0001). No difference was seen concerning leaks or strictures. The relative risk (RR) of leakage after LS was 80% of the risk after CS; however, the 95% confidence interval (CI) showed overlap (0.58–1.11). The RR of anastomotic stricture after LS was 74% of the risk after CS; however, 95% CI (0.52–1.05) showed overlap. Wound infections were less common after LS than after CS; RR was 27% (95% CI 0.21–0.33). Length of stay (LOS) was 0.65 days shorter after LS than after CS (95% CI 0.51–0.78). LS compared with CS results in shorter operative time, less wound infections, and shorter length of stay, but no difference was seen concerning risks of leaks or strictures.


Morbid obesity Gastric bypass Laparoscopic gastric bypass Gastro-jejunostomy Circular stapler Linear stapler Complications Stapling technique 


Compliance with Ethical Standards

Conflict of Interest

The author received funding from Swedish medical council.

Ethical Approval

For this type of study, formal consent is not required.

Informed Consent

Does not apply.

Supplementary material

11695_2019_3803_MOESM1_ESM.pdf (56 kb)
ESM 1 (PDF 55.9 kb)
11695_2019_3803_MOESM2_ESM.pdf (55 kb)
ESM 2 (PDF 55.4 kb)
11695_2019_3803_MOESM3_ESM.pdf (55 kb)
ESM 3 (PDF 55.4 kb)


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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Department of Surgery and Department of Clinical and Experimental MedicineLinköping UniversityLinkopingSweden
  2. 2.University Hospital LinköpingLinkopingSweden

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