Assessment of the Correlation Between Preoperative and Immediate Postoperative Gastric Volume and Weight Loss After Sleeve Gastrectomy Using Computed Tomography Volumetry
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Laparoscopic sleeve gastrectomy (LSG) has achieved excellent results in treatment of morbid obesity. The present study aimed to evaluate the impact of the preoperative gastric volume, volume of the remaining gastric pouch, and volume of the resected stomach on weight loss after LSG.
Patients with morbid obesity who underwent LSG were investigated by CT volumetry before and 1 week after LSG to measure the volume of the stomach before and after the procedure, and the volume of the resected stomach was also calculated. The percentage of excess weight loss (EWL) and decrease in body mass index (BMI) at 6 months postoperatively were measured and correlated with preoperative and postoperative gastric volumes.
Forty-seven patients (44 females) were included to the study. A significant decrease in the gastric volume and BMI after LSG was noted. Preoperative gastric volume was positively correlated with preoperative BMI (r = 0.723, p < 0.00001) but not correlated with %EWL at 6 months. The volume of the remaining gastric pouch was positively correlated with BMI at 6 months postoperatively (r = 0.597, p < 0.00001) and negatively correlated with %EWL (r = −0.7495, p < 0.00001). The correlation between the size of resected stomach and %EWL was statistically insignificant, yet the mean percentage of the resected stomach was directly correlated to %EWL.
The preoperative volume of the stomach was positively correlated with baseline BMI, but not correlated with %EWL. The size of the remaining gastric pouch and the percentage of the resected stomach had significant impact on %EWL after LSG.
Hossam Elbanna designed the study, contributed to data collection and analysis and writing of the manuscript. Sameh Emile contributed in data collection and analysis and writing of the manuscript. Galal El-Hawary and Hossam Zaytoun performed CT volumetry for the patients before and after surgery and contributed to data collection and analysis. Noha Abdelsalam contributed to data analysis and writing and critical revision of the manuscript. Ahmed Ghanem and Haitham Elkaffas contributed to data collection, drafting and revision of the manuscript.
Compliance with ethical standards
Conflict of interest
All authors declare no conflicts of interest related to this article.
- 11.Peterli R, Wölnerhanssen BK, Vetter D, Nett P, Gass M, Borbély Y et al (2017) Laparoscopic sleeve gastrectomy versus Roux-Y-gastric bypass for morbid obesity-3-year outcomes of the prospective randomized Swiss Multicenter Bypass or Sleeve Study (SM-BOSS). Ann Surg 265(3):466–473. https://doi.org/10.1097/SLA.0000000000001929 CrossRefGoogle Scholar
- 15.Goitein D, Lederfein D, Tzioni R, Berkenstadt H, Venturero M, Rubin M (2012) Mapping of ghrelin gene expression and cell distribution in the stomach of morbidly obese patients—a possible guide for efficient sleeve gastrectomy construction. Obes Surg 22:617–622. https://doi.org/10.1007/s11695-011-0585-9 CrossRefGoogle Scholar
- 19.Sherwood L (1997) Human physiology: from cells to systems. Belmont, CA: Wadsworth Pub. Co. ISBN: 0-314-09245-5. OCLC 35270048Google Scholar
- 20.Granstrom L, Backman L (1985) Stomach distension in extremely obese and in normal subjects. Acta Chir Scand 151:367–370Google Scholar
- 24.Rosas U, Hines H, Rogan D, Rivas H, Morton J (2015) The influence of resected gastric weight upon weight loss after sleeve gastrectomy. Am Surg 81(12):1240–1243Google Scholar
- 25.Deguines JB, Verhaeghe P, Yzet T, Robert B, Cosse C, Regimbeau JM (2013) Is the residual gastric volume after laparoscopic sleeve gastrectomy an objective criterion for adapting the treatment strategy after failure? Surg Obes Relat Dis 9(5):660–666. https://doi.org/10.1016/j.soard.2012.11.010 CrossRefGoogle Scholar