Comparison of Stapled and Hand-Sutured Gastrectomies

We reviewed 585 Billroth II gastrectomies to compare the results of stapled and hand-sutured cases. In 385 patients who had the duodenal stump handled by conventional methods, 18 (4.7%) leaked, compared with four (2.5%) leaks in 160 patients who had the duodenal stump stapled. In 474 hand-sutured anastomoses, there were 12 complications (leaks, hemorrhage, or obstruction), whereas there were no complications in 71 stapled anastomoses. We conclude that stapling provides an expedient way of performing gastrectomies that is at least as safe if not safer than conventional hand suture.