Variation in Small Bowel Length and Its Influence on the Outcomes of Sleeve Gastrectomy
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ORIGINAL CONTRIBUTIONS
Variation in Small Bowel Length and Its Influence on the Outcomes of Sleeve Gastrectomy Owaid M. Almalki 1,2 & Tien-Chou Soong 3,4,5 & Wei-Jei Lee 2
&
Jung-Chien Chen 2 & Chun-Chi Wu 2 & Yi-Chih Lee 6
Received: 18 June 2020 / Revised: 28 August 2020 / Accepted: 2 September 2020 # Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract Purpose Small bowel length is drawing attention in the development of gastrointestinal bariatric/metabolic surgery, but the importance of the length of the small bowel in bariatric/metabolic is not clear. The present study was conducted to investigate variations in small bowel length and their clinical significance in patients undergoing laparoscopic sleeve gastrectomy (LSG). Materials and Methods Small bowel length was measured in 620 patients diagnosed with obesity who underwent LSG between March 2014 and August 2018. Prospectively obtained demographic and clinical data were investigated, focusing on the association between small bowel length and weight loss. Results Small bowel length varied widely among patients (mean 739.8 + 115.7 cm, range 380–1050 cm). Linear regression analysis revealed a significant association between small bowel length and body height, body weight, waist circumference, and serum levels of low-density lipoprotein cholesterol, hemoglobin, C-peptide, glycated hemoglobin (A1C), and gamma-glutamyl transferase (r-GT). Multivariate analysis confirmed that body height and serum A1C% levels independently predicted small bowel length in bariatric patients, strongly with body height (p < 0.001) but weakly with A1C%(p = 0.021). One-year follow-up rate was 75.3% (467/620), and small bowel length did not influence weight loss or the reduction of obesity related cardiovascular risk factors after LSG. Conclusion In this study, small bowel length varied widely among bariatric patients and was strongly associated with body height and weakly with serum A1C levels. Small bowel length has no significant role in weight loss or the resolution of cardiovascular risk factors after LSG. Keywords Small bowel length . Weight loss . Sleeve gastrectomy
Introduction
* Wei-Jei Lee [email protected] 1
Department of Surgery, College of Medicine, Taif University, Ta’if, Saudi Arabia
2
Department of Surgery, Min-Sheng General Hospital, No. 168, Ching Kuo Road, Taoyuan, Taiwan
3
Department of Weight Loss and Health Management Center, E-DA Dachang Hospital, Kaohsiung, Taiwan
4
Department of Asia Obesity Medical Research Center, E-DA Hospital, Kaohsiung, Taiwan
5
College of Medicine, I-Shou University, Kaohsiung, Taiwan
6
Department of International Business, Chien Hsin University, Taoyuan, Taiwan
Bariatric surgery is an effective treatment for patients with morbid obesity and provides significant and lasting weight reduction and resolution of obesity-induced comorbidities [1, 2]. However, bariatric surgery procedures continue to evolve, and several novel techniques are being investigated as innovative approaches to treat
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