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Related Experiment Video

Updated: Mar 28, 2026

An Ivor Lewis Esophagectomy Designed to Minimize Anastomotic Complications and Optimize Conduit Function
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Staple Line Bleeding in Sleeve Gastrectomy-a Simple and Cost-Effective Solution.

Saurav Chakravartty1, Diwakar R Sarma1, Avril Chang1

  • 1Department of Surgery, King's College Hospital NHS Foundation Trust, Denmark Hill, London, SE5 9RS, UK.

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|December 24, 2015
PubMed
Summary

Intraoperative tranexemic acid significantly reduced staple line bleeding during laparoscopic sleeve gastrectomy. This simple, economical approach decreased the need for interventions and shortened operating times without increasing complications.

Keywords:
Sleeve gastrectomyStaple line bleedingTranexemic acid

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Area of Science:

  • Bariatric Surgery
  • Surgical Complications
  • Hemostasis

Background:

  • Staple line bleeding (SLB) is a frequent intraoperative complication in laparoscopic sleeve gastrectomy (SG).
  • Current management strategies for SLB, including reinforcement, suturing, and diathermy, have varying efficacy and cost implications.
  • Tranexemic acid, an antifibrinolytic agent, is recognized for its hemostatic properties in other surgical contexts.

Purpose of the Study:

  • To evaluate the efficacy of intraoperative tranexemic acid in reducing staple line bleeding during laparoscopic sleeve gastrectomy.
  • To compare the number of bleeding points requiring intervention between patients receiving tranexemic acid and a control group.

Main Methods:

  • A prospective matched comparative study involving laparoscopic sleeve gastrectomy patients.
  • One cohort received tranexemic acid (1g) intraoperatively, while the control group did not.
  • Primary outcome: number of staple line bleeding points requiring intervention; secondary outcomes: estimated blood loss and operating time.

Main Results:

  • The tranexemic acid group required significantly fewer haemostatic stitches for staple line bleeding (19 vs. 46, p < 0.05).
  • Intraoperative blood loss was significantly reduced in the treatment group (p < 0.01).
  • Operating times were significantly shorter in patients receiving tranexemic acid (median 66 vs. 80 min, p < 0.05).

Conclusions:

  • Intraoperative prophylactic tranexemic acid is a simple, economical, and effective method for reducing staple line bleeding in SG.
  • The use of tranexemic acid leads to a significant decrease in operative time.
  • No differences in morbidity or mortality were observed between the groups.