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Geometry of Sleeve Gastrectomy Measured by 3D CT Versus Weight Loss: Preliminary Analysis

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Abstract

Background

The size of the remnant stomach with respect to weight loss failure after laparoscopic sleeve gastrectomy (LSG) remains controversial. This study aimed to evaluate the impact of the actual size and volume of the remnant stomach, as measured by three-dimensional computed tomography (3D-CT) volumetry, on weight loss after LSG.

Methods

The clinical outcomes of 52 patients who underwent LSG between October 2008 and February 2019 were assessed. Weight metrics were recorded at 1, 3, and 6 months and 1 year postoperatively. 3D-CT volumetry was performed 1 year postoperatively, and the total remnant stomach volume (TSV), proximal stomach volume (PSV), antral stomach volume (ASV), and the distance between the pylorus and the distal edge of staple line (DPS) were measured. The relationship between the weight metrics and aforementioned factors was analyzed.

Results

Of the 52 patients who underwent LSG, 40 patients participated in this study. The average body mass index preoperatively was 38.3 ± 5.1 kg/m2, and the average percentage of total weight loss (%TWL) 1 year after LSG was 26.6 ± 9.3%. The average TSV, PSV, ASV, and DPS were 123.2 ± 60.3 ml, 73.4 ± 37.2 ml, 49.8 ± 30.3 ml, and 59.9 ± 18.5 mm, respectively. The DPS (r = − 0.394, p = 0.012) and ASV (r = − 0.356, p = 0.024) were correlated with %TWL 1 year postoperatively.

Conclusions

The actual DPS and ASV measured by 3D-CT affected weight loss after LSG. 3D-CT may be useful for the immediate identification of factors affecting insufficient weight loss in patients; this may, in turn, aid in the implementation of early intervention treatments.

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Acknowledgements

We acknowledge the work of Ms. Mika Kurihara, Ms. Mitsuko Ando, Mr. Yuki Kaminishi, Ms. Momoe Hattori, and Ms. Michiko Miura for collecting patient data and supporting surgery or patient care.

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Authors and Affiliations

  1. Department of Surgery, Shiga University of Medical Science, Tsukinowa-cho, Seta, Otsu, Shiga, 520-2192, Japan

    Tsuyoshi Yamaguchi, Sachiko Kaida, Toru Miyake & Masaji Tani

  2. Department of Surgery, Kohnan Hospital, 958, Katsuragi, Konan-cho, Koka, Shiga, 520-3321, Japan

    Hiroshi Yamamoto

  3. Department of Radiology, Shiga University of Medical Science, Tsukinowa-cho, Seta, Otsu, Shiga, 520-2192, Japan

    Yuki Tomozawa & Yoshiyuki Watanabe

  4. Department of Medicine, Shiga University of Medical Science, Tsukinowa-cho, Seta, Otsu, Shiga, 520-2192, Japan

    Satoshi Ugi, Katsutaro Morino & Hiroshi Maegawa

Authors
  1. Tsuyoshi Yamaguchi
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  2. Hiroshi Yamamoto
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Correspondence to Tsuyoshi Yamaguchi.

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Conflict of interest

None of the authors has any conflict of interest or any financial ties to disclose.

Informed consent

Written informed consent was obtained from all individual participants included in the study.

Human and Animal Rights

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Declaration of Helsinki and its later amendments or comparable ethical standards. The institutional ethical review board of Shiga University of Medical Science Hospital approved the study (Approval Number: 18-77-4, R2019-116).

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Yamaguchi, T., Yamamoto, H., Tomozawa, Y. et al. Geometry of Sleeve Gastrectomy Measured by 3D CT Versus Weight Loss: Preliminary Analysis. World J Surg 45, 235–242 (2021). https://doi.org/10.1007/s00268-020-05807-5

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  • DOI: https://doi.org/10.1007/s00268-020-05807-5

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