Sleeve Volume and Preoperative Gastric Volume Assessment Using Three-dimensional MDCT Gastrography and Their Correlation
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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 Islam A. El-Sayes 1 & Tamer N. Abdelbaki 1 & Mohamed A. Sharaan 1 & Mohamed S. Shaaban 2 & Mohamed M. El Shafei 2 & Mostafa R. Elkeleny 1 Received: 23 July 2020 / Revised: 22 September 2020 / Accepted: 24 September 2020 # Springer Science+Business Media, LLC, part of Springer Nature 2020
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. Keywords MDCT gastrography . Sleeve gastrectomy . Sleeve volume
Introduction Laparoscopic sleeve gastrectomy (LSG) is currently the most commonly performed bariatric procedure worldwide [1–3]. In a recent report, sleeve gastrectomy represented almost 60% of the worldwide bariatric practice in the time period from 2015 to 2018 [1]. This is mainly attributed to its excellent outcomes
* Islam A. El-Sayes [email protected] 1
General Surgery Department, Faculty of Medicine, Alexandria University, Alexandria, Egypt
2
Department of Diagnostic and Interventional Radiology, Faculty of Medicine, Alexandria University, Alexandria, Egypt
in terms of weight loss and resolution of comorbidities [1, 2] with lower complication rates and nutritional deficiencies compared with other malabsorptive procedures [2, 4]. Accordingly, factors behind its
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