Early post-operative weight loss after laparoscopic sleeve gastrectomy correlates with the volume of the excised stomach and not with that of the sleeve! Preliminary data from a multi-detector computed tomography-based study

Abstract

MDCT is a good method to measure gastric volume before and after LSG. Early post-operative weight loss (3 months) correlates well with the volume of the excised stomach but not with that of the gastric sleeve.

Correlation of weight loss with residual gastric volume on computerized tomography in patients undergoing sleeve gastrectomy: A systematic review

“…We found records of 428 patients from the 10 included studies studying the correlation of RGV after sleeve gastrectomy with weight loss. Table 1 shows the important characteristics of these studies 9,10,13‐20 . The mean age and BMI of the patients were 38.57 years and 44.99 kg/m 2 , respectively.…”

“…Three studies reported oversewing of the staple line, 16,17,20 and in one study, sewing of omentum to the staple line was performed 13 . In another study, no staple line reinforcement was used 9 . In majority of the included studies, CT volumetry was performed using an effervescent solution of 4 mg of Sodium Bicarbonate granules or tartaric acid/ sodium hydrogen carbonate salts to distend the stomach remnant with gas.…”

“…In this review, we found extremely variable estimates of correlation between RGV and weight loss, with several studies reporting a significant correlation 13‐16 to one reporting weak correlation 19 . Two studies reported that the resected gastric volume rather than the RGV has a significant correlation with excess weight loss 9,10 . The sample size in one of these studies was small and the correlation between the RGV and weight loss was studied at a short follow‐up of 3 months which might be the reason for not finding any correlation between RGV and weight loss 9 .…”

“…There has been significant interest in the association of the volume of the resected specimen with weight loss. Studies in the past have shown divergent results, with strength of correlation between volume of resected specimen and excess weight loss varying from large 8‐10 to no correlation 11,12 . Current understanding is that the residual gastric volume (RGV) might be a more reliable variable to study, as the volume of the resected stomach might vary significantly with the preoperative stomach volume.…”

MDCT imaging of the stomach: advances and applications

“…Advances in the CT technology and three-dimensional (3D) post-processing software have enabled new exciting possibilities like CT-based endoscopic images [virtual endoscopy (VE)] 1 as well as allowed accurate staging for neoplastic diseases of the stomach 2 and predict the post-operative weight loss for patients undergoing bariatric surgery. 3 It is very important for a radiologist to understand the appropriate gastric imaging protocol, since the acquisition of appropriate CT images requires patient fasting, adequate gastric distension and a negative intraluminal contrast agent. This article describes the basic principle and protocol for multidetector CT (MDCT) of the stomach and reviews the role of CT for the diagnosis of various gastric pathologies and post-operative surveillance.…”