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Laboratory results were retrieved from the hospital information system (data available on 105 patients) and the medical records reviewed retrospectively (records available on 86 patients). Presence of a gastrojejunal anastomosis leak was proven by contrast extravasation in a radiological study or at the time of reoperation. Demographic data of all the patients are displayed in Table I. There were no significant differences between patients with and without leaks in terms of age, sex, body mass index (BMI) or co-morbidities. Hospital stay was significantly longer in patients with leaks (Table I). Table I Demographic data Surgical technique The RYGB was performed through five ports, the gastric pouch being formed over a 32 Fr gauge (FG) bougie and extending http://www.selleckchem.com/products/rgfp966.html to between selleck screening library the second and third vessel on the lesser curve side of the stomach. A side-to-side, antecolic gastrojejunostomy was formed using 25 mm of an Ethicon Echelon Endocutter 45-mm linear Gold cartridge. The anterior aspect of anastomosis was closed over a 32 FG bougie with a single layer of 2-0 Vicryl or 2-0 polydioxanone (PDS). The jejunojejunostomy was a side-to-side anastomosis formed with one firing of a 60-mm linear stapler (White cartridge) with enterotomy being closed in one layer with a continuous 2-0 PDS suture. The anastomoses were checked for integrity using a combination of methylene blue (120 ml) and air insufflations through a nasogastric (NG) tube. Drain placement was at the discretion of the surgeon. All procedures were completed laparoscopically. Postoperative assessment After surgery, pulse rate, blood pressure, body temperature, postoperative pain and fluid balance over a period of 24 h were measured from day 1 to 3. Data were collected as the average and range of pulse rate, systolic blood pressure, maximum temperature (in degrees Celsius), pain scores (1 is none, 2 mild, 3 moderate and 4 severe) and balance of fluid input and output in ml. A normal white cell count was between 4 and 12 �� 109 cells/ml and the serum CRP normal value PDK4 range was 0�C5 mg/l. A postoperative Gastrografin study was not performed routinely. Statistical analysis The statistical analysis was performed using SPSS for Windows, release 17.0 (SPSS, Chicago, Ill., USA). Comparison between patient groups with and without leaks was performed using the ��2 test and Mann-Whitney test as appropriate. Significance was defined as a p value