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Sleeve Volume and Preoperative Gastric Volume Assessment Using Three-dimensional MDCT Gastrography and Their Correlation to Short-term Post-Sleeve Gastrectomy Weight Loss

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Abstract

Purpose

Several factors including preoperative stomach capacity and sleeve volume impact weight loss after laparoscopic sleeve gastrectomy (LSG). We aimed at measuring these volumes using multidetector computed tomography (MDCT) gastrography and correlating them with postoperative weight losses.

Materials and Methods

Morbidly obese patients prepared for LSG during 2018 were included in the study. MDCT gastrography was performed 1 week before, 6 and 12 months after LSG. Preoperative gastric volume and postoperative sleeve volumes were measured. Correlation with preoperative BMI and postoperative %TWL was performed. The change in sleeve volume at 6 and 12 months was assessed.

Results

A total of 98 patients (62 F) were included. Mean preoperative BMI was47 ± 7 kg/m2. Follow-up was achieved in 89 patients (91%) and 82 patients (83%) at 6 and 12 months, respectively. Mean %TWL was 24 ± 3 and 32.8 ± 3 at 6 and 12 months, respectively (p < 0.05). Preoperative gastric volume ranged from 800 to 1800 ml (mean ± SD, 1310 ± 307) and dropped significantly to range from 140 to 170 ml (158 ± 9) and from 165 to 210 ml (181 ± 12) at 6 and 12 months postoperatively, respectively. Pouch was not significantly dilated at 12 vs. 6 months postoperatively. Preoperative gastric volume was significantly correlated with preoperative BMI (p = 0.006*) but not with postoperative weight losses. Correlation between postoperative pouch volumes and weight losses at 6 and 12 months postoperatively showed no significance.

Conclusion

Sleeve pouch is significantly smaller than preoperative stomach, but not significantly correlated to weight loss. Restriction is an important, but not the only factor controlling weight loss after LSG.

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References

  1. Ramos A, Kow L, Brown W, Welbourn R, Dixon J, Kinsman R, et al. The IFSO Global Registry United Kingdom: Dendrite Clinical Systems Ltd; 2019 [Available from: https://www.ifso.com/pdf/5th-ifso-global-registry-report-september-2019.pdf].

  2. Mechanick JI, Apovian C, Brethauer S, et al. Clinical Practice Guidelines For The Perioperative Nutrition, Metabolic, and nonsurgical support of patients undergoing bariatric procedures - 2019 update: cosponsored by American Association Of Clinical Endocrinologists/American College Of Endocrinology, the Obesity Society, American Society For Metabolic & Bariatric Surgery, Obesity Medicine Association, and American Society Of Anesthesiologists - executive summary, Endocrine practice: official journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists. 2019;25(12):1346–59.

  3. Kizy S, Jahansouz C, Downey MC, et al. National trends in bariatric surgery 2012-2015: demographics, procedure selection, readmissions, and cost. Obes Surg. 2017;27(11):2933–9.

    Article  Google Scholar 

  4. Young MT, Gebhart A, Phelan MJ, et al. Use and outcomes of laparoscopic sleeve gastrectomy vs laparoscopic gastric bypass: analysis of the American College of Surgeons NSQIP. J Am Coll Surg. 2015;220(5):880–5.

    Article  Google Scholar 

  5. Kueper MA, Kramer KM, Kirschniak A, et al. Laparoscopic sleeve gastrectomy: standardized technique of a potential stand-alone bariatric procedure in morbidly obese patients. World J Surg. 2008;32(7):1462–5.

    Article  Google Scholar 

  6. Weiner RA, Weiner S, Pomhoff I, et al. Laparoscopic sleeve gastrectomy—influence of sleeve size and resected gastric volume. Obes Surg. 2007;17(10):1297–305.

    Article  Google Scholar 

  7. Yehoshua RT, Eidelman LA, Stein M, et al. Laparoscopic sleeve gastrectomy—volume and pressure assessment. Obes Surg. 2008;18(9):1083.

    Article  Google Scholar 

  8. Langer FB, Bohdjalian A, Felberbauer FX, et al. Does gastric dilatation limit the success of sleeve gastrectomy as a sole operation for morbid obesity? Obes Surg. 2006;16(2):166–71.

    Article  Google Scholar 

  9. Braghetto I, Cortes C, Herquiñigo D, et al. Evaluation of the radiological gastric capacity and evolution of the BMI 2–3 years after sleeve gastrectomy. Obes Surg. 2009;19(9):1262–9.

    Article  Google Scholar 

  10. Baumann T, Grueneberger J, Pache G, et al. Three-dimensional stomach analysis with computed tomography after laparoscopic sleeve gastrectomy: sleeve dilation and thoracic migration. Surg Endosc. 2011;25(7):2323–9.

    Article  Google Scholar 

  11. Pomerri F, Foletto M, Allegro G, et al. Laparoscopic sleeve gastrectomy—radiological assessment of fundus size and sleeve voiding. Obes Surg. 2011;21(7):858–63.

    Article  Google Scholar 

  12. Ramón JM, Salvans S, Crous X, et al. Effect of roux-en-Y gastric bypass vs sleeve gastrectomy on glucose and gut hormones: a prospective randomised trial. J Gastrointest Surg. 2012;16(6):1116–22.

    Article  Google Scholar 

  13. Panel CDC. Gastrointestinal surgery for severe obesity. Ann Intern Med. 1991;115(12):956–61.

    Article  Google Scholar 

  14. Gagner M, Deitel M, Erickson AL, Crosby RD. Survey on laparoscopic sleeve gastrectomy (LSG) at the Fourth International Consensus Summit on Sleeve Gastrectomy. Obesity surgery. 2013;23(12).

  15. Stroh C, Groh C, Weiner R, et al. Are there gender-specific aspects of gastric banding? Data analysis from the quality assurance study of the surgical treatment of obesity in Germany. Obes Surg. 2013;23(11):1783–9.

    Article  Google Scholar 

  16. Doğan S, Önmez A, Çetin MF, et al. Residual gastric volume relationship and weight loss after laparoscopic sleeve gastrectomy. Obes Surg. 2020;30(5):1929–34.

    Article  Google Scholar 

  17. Csendes A, Burgos AM. Size, volume and weight of the stomach in patients with morbid obesity compared to controls. Obes Surg. 2005;15(8):1133–6.

    Article  Google Scholar 

  18. Delgado-Aros S, Cremonini F, Castillo JE, et al. Independent influences of body mass and gastric volumes on satiation in humans. Gastroenterology. 2004;126(2):432–40.

    Article  Google Scholar 

  19. Kim DY, Camilleri M, Murray JA, et al. Is there a role for gastric accommodation and satiety in asymptomatic obese people? Obes Res. 2001;9(11):655–61.

    Article  CAS  Google Scholar 

  20. Pawanindra L, Vindal A, Midha M, et al. Early post-operative weight loss after laparoscopic sleeve gastrectomy correlates with the volume of the excised stomach and not with that of the sleeve! Preliminary data from a multi-detector computed tomography-based study. Surg Endosc. 2015;29(10):2921–7.

    Article  Google Scholar 

  21. Elbanna H, Emile S, El-Hawary GE-S, et al. Assessment of the correlation between preoperative and immediate postoperative gastric volume and weight loss after sleeve gastrectomy using computed tomography volumetry. World J Surg. 2019;43(1):199–206.

    Article  Google Scholar 

  22. Singh JP, Tantia O, Chaudhuri T, et al. Is resected stomach volume related to weight loss after laparoscopic sleeve gastrectomy? Obes Surg. 2014;24(10):1656–61.

    Article  Google Scholar 

  23. Bekheit M, Abdel-Baki TN, Gamal M, et al. Influence of the resected gastric volume on the weight loss after laparoscopic sleeve gastrectomy. Obes Surg. 2016;26(7):1505–10.

    Article  Google Scholar 

  24. Karcz W, Kuesters S, Marjanovic G, et al. 3D-MSCT gastric pouch volumetry in bariatric surgery—preliminary clinical results. Obes Surg. 2009;19(4):508–16.

    Article  CAS  Google Scholar 

  25. Doğan S, Önmez A, Çetin MF, et al. Residual gastric volume relationship and weight loss after laparoscopic sleeve gastrectomy. Obes Surg. 2020:1–6.

  26. Vidal P, Ramón JM, Busto M, et al. Residual gastric volume estimated with a new radiological volumetric model: relationship with weight loss after laparoscopic sleeve gastrectomy. Obes Surg. 2014;24(3):359–63.

    Article  Google Scholar 

  27. Fahmy MH, Sarhan MD, Osman AM, et al. Early weight recidivism following laparoscopic sleeve gastrectomy: a prospective observational study. Obes Surg. 2016;26(11):2654–60.

    Article  Google Scholar 

  28. Vidal P, Ramon JM, Busto M, et al. Residual gastric volume estimated with a new radiological volumetric model: relationship with weight loss after laparoscopic sleeve gastrectomy. Obes Surg. 2014;24(3):359–63.

    Article  Google Scholar 

  29. Langer FB, Reza Hoda MA, Bohdjalian A, et al. Sleeve gastrectomy and gastric banding: effects on plasma ghrelin levels. Obes Surg. 2005;15(7):1024–9.

    Article  CAS  Google Scholar 

  30. Li F, Zhang G, Liang J, et al. Sleeve gastrectomy provides a better control of diabetes by decreasing ghrelin in the diabetic Goto-Kakizaki rats. Journal of gastrointestinal surgery: official journal of the Society for Surgery of the Alimentary Tract. 2009;13(12):2302–8.

    Article  Google Scholar 

  31. Pereferrer FS, Gonzàlez MH, Rovira AF, et al. Influence of sleeve gastrectomy on several experimental models of obesity: metabolic and hormonal implications. Obes Surg. 2008;18(1):97–108.

    Article  Google Scholar 

  32. Melissas J, Daskalakis M, Koukouraki S, et al. Sleeve gastrectomy—a “food limiting” operation. Obes Surg. 2008;18(10):1251–6.

    Article  Google Scholar 

  33. Baraki Y, Traverso P, Elariny H, et al. Preoperative prediction of stomach weight to be removed in laparoscopic sleeve gastrectomy procedure. Surgical Technology International. 2010;20:167–71.

    PubMed  Google Scholar 

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Authors and Affiliations

  1. General Surgery Department, Faculty of Medicine, Alexandria University, Alexandria, Egypt

    Islam A. El-Sayes, Tamer N. Abdelbaki, Mohamed A. Sharaan & Mostafa R. Elkeleny

  2. Department of Diagnostic and Interventional Radiology, Faculty of Medicine, Alexandria University, Alexandria, Egypt

    Mohamed S. Shaaban & Mohamed M. El Shafei

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  1. Islam A. El-Sayes
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  2. Tamer N. Abdelbaki
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  3. Mohamed A. Sharaan
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Correspondence to Islam A. El-Sayes.

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An informed consent was obtained from all individual participants included in this study.

All procedures performed in the study were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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El-Sayes, I.A., Abdelbaki, T.N., Sharaan, M.A. et al. Sleeve Volume and Preoperative Gastric Volume Assessment Using Three-dimensional MDCT Gastrography and Their Correlation to Short-term Post-Sleeve Gastrectomy Weight Loss. OBES SURG 31, 490–498 (2021). https://doi.org/10.1007/s11695-020-05012-2

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  • DOI: https://doi.org/10.1007/s11695-020-05012-2

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