Impact of 3D-CT-Based Gastric Wall Volume on Weight Loss after Laparoscopic Sleeve Gastrectomy
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ORIGINAL CONTRIBUTIONS
Impact of 3D-CT-Based Gastric Wall Volume on Weight Loss after Laparoscopic Sleeve Gastrectomy Chih-Hao Lin 1,2 & Yu Hsu 3 & Chi-Ling Chen 4 & Wei-Shiung Yang 4,5,6 & Po-Chu Lee 1,5 & Chiung-Nien Chen 1,5 & Ming-Tsan Lin 1 & Chih-Horng Wu 3,4 & Po-Jen Yang 1,5
# Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract Purpose There are several debates on the association between gastric anatomy and weight loss after laparoscopic sleeve gastrectomy (LSG). There is a paucity of data on the impact of gastric wall volume (GWV) on weight loss. This study therefore aimed to investigate the effect of GWV on weight loss response after LSG. Materials and Methods Thirty-two patients with body mass index (BMI) of ≧ 40 kg/m2 who underwent LSG between November 2016 and August 2018 were enrolled. Three-dimensional computed tomography (3D-CT) was performed pre-operatively and 1 year after LSG to assess gastric volumes. The population was divided into two groups: the first 20% (n = 7) with the largest GWV, defined as LGWV group, and the rest of the population (n = 25), defined as the small GWV (SGWV) group. Percentage total weight loss (%TWL) was compared. Results The mean preoperative GWV was 216.9 ± 47.7 ml in the SGWV group, versus 336.3 ± 24.1 ml in the LGWV group. Patients with LGWV had significantly lower 1-year %TWL (34.9.1% versus 27.9%, p = 0.0439). Multilinear regression identified LGWV as a significant prognostic factor after adjusting for BMI and early weight loss response. Repeated measure mixed effect model showed that the LGWV group had a significantly slower %TWL change, particularly after 3 months postoperatively. No association was found between 1-year %TWL and preoperative and postoperative gastric luminal volume or resected gastric volume. Conclusion 3D-CT disclosed GWV, but not other gastric anatomical characteristics, was an independent predictor of %TWL after 1-year post LSG. Keywords Laparoscopic sleeve gastrectomy . Weight loss . Gastric wall volume . Gastric luminal volume . Resected gastric volume Chih-Horng Wu and Po-Jen Yang contributed equally to this work. * Po-Jen Yang [email protected]
Chih-Horng Wu [email protected]
Chih-Hao Lin [email protected]
1
Yu Hsu [email protected]
Department of Surgery, National Taiwan University Hospital, Taipei, Taiwan
2
Department of Surgery, Sinwu Branch, Tao Yuan General Hospital, Ministry of Health and Welfare, Tao Yuan, Taiwan
3
Department of Medical Imaging, National Taiwan University Hospital, Taipei, Taiwan
4
Graduate Institute of Clinical Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan
5
Center for Obesity, Life Style, and Metabolic Surgery, National Taiwan University Hospital, Taipei, Taiwan
6
Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan
Chi-Ling Chen [email protected] Wei-Shiung Yang [email protected] Po-Chu Lee [email protected] Chiung-Nien Chen [email protected] Ming-Tsan Lin [email protected]
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