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Dilatation of Sleeve Gastrectomy: Myth or Reality?

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Abstract

Objectives

The success of longitudinal sleeve gastrectomy (LSG) is perceived as being potentially limited by dilatation of the remaining gastric tube during the follow-up. The aim of this prospective study was to determine the incidence and the characteristics of sleeve dilatation during the first post-operative year.

Materials and Methods

Gastric volumetry using 3D gastric computed tomography with gas expansion was performed in 54 successive subjects who underwent an LSG for morbid obesity at 3 and 12 months following surgery. Total gastric volume, volume of the gastric tube and the antrum, and diameter of the gastric tube were assessed after multiplanar reconstructions. An increase of at least 25 % of the total gastric volume was considered as sleeve dilatation. Percentage of excess BMI loss (%EBMIL) and daily caloric intakes were recorded during the first 18 months.

Results

Sixty-one percent of the subjects experienced sleeve dilatation 1 year after surgery. The gastric tube was mainly involved in the sleeve dilatation process (+91 %). Sleeve dilatation occurred especially in subjects with smaller total gastric volume at baseline (189 vs 236 ml, p = 0.02). Daily caloric intake was similar between the groups at each point of the follow-up. No difference concerning %EBMIL was observed between the groups during the 18 months of follow-up.

Conclusions

Sleeve dilatation occurred in more than 50 % of the patients. Dilatation was not necessarily linked to an increase of daily caloric intake and insufficient weight loss during the first 18 months following surgery. Small LSG at baseline is at higher risk of dilatation.

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Authors and Affiliations

  1. Hospices Civils de Lyon, Lyon, France

    Emmanuel Disse, Arnaud Pasquer, Elise Pelascini, Pierre-Jean Valette, Cecile Betry, Martine Laville, Christian Gouillat & Maud Robert

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  1. Emmanuel Disse
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  2. Arnaud Pasquer
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  3. Elise Pelascini
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  4. Pierre-Jean Valette
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  5. Cecile Betry
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  6. Martine Laville
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  7. Christian Gouillat
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  8. Maud Robert
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Corresponding author

Correspondence to Emmanuel Disse.

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Conflict of Interest

The authors declare that they have no conflict of interest.

Ethical Approval

All procedures performed in this study were in accordance with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed Consent

All the subjects were included after written informed consent.

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Disse, E., Pasquer, A., Pelascini, E. et al. Dilatation of Sleeve Gastrectomy: Myth or Reality?. OBES SURG 27, 30–37 (2017). https://doi.org/10.1007/s11695-016-2261-6

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  • DOI: https://doi.org/10.1007/s11695-016-2261-6

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